创伤性脑损伤昏迷患者默认网络功能连接的静息态fMRI研究

Study on Resting-state f MRI of Functional Connectivity of Default Mode Network in Coma Patients with Traumatic Brain Injury

目的:探讨创伤性脑损伤昏迷患者静息态功能磁共振成像(resting-state functional magnetic resonance imaging,rs-f MRI)中默认网络(default mode network,DMN)改变情况及其与后扣带回(posterior cingulate cortex,PCC)的功能连接特点。方法:收集2013年6月至11月在河北医科大学附属衡水哈励逊国际和平医院神经外科入院治疗的创伤性脑损伤昏迷患者23例为试验组,同时选取性别,年龄,受教育程度相匹配的右利手健康志愿者23例作为对照组,所有研究对象完成静息态功能磁共振成像,选择感兴趣区并作功能连接分析比较两组患者的差异。结果:正常对照组的PCC功能连接图与假设的默认网络完全匹配(P<0.05)。颅脑损伤性昏迷患者和PCC呈显著正连接的区域比正常对照组和PCC显著正连接的区域明显减少(P<0.05)。结论:静息状态下颅脑损伤性昏迷患者默认状态网络系统存在,但范围减小,颅脑损伤性昏迷患者在静息状态下与健康对照相比多个脑区与PCC的功能连接显著减弱。

Objective： To explore whether the default mode network（ DMN） in patients with traumatic coma is abnormal or not in resting-state functional magnetic resonance imaging（ rs-f MRI） and functional connectivity characteristics with posterior cingulate cortex（ PCC）. Method： 23 cases with traumatic brain injury were selected as the objects in experimental group,and 23 cases of healthy volunteers with the matched gender,age and education were selected on the objects in control group. All the objects received resting-state f MRI,and then,the region of interest was taken,the functional connectivity was analyzed and compared between the two groups. Result： Single T test showed that the graph of PCC functional connection in the normal contral group almost completely match with the assumptive default mode network（ P,0. 05）. Compared with normal control group,the range of connection of default mode network and PCC was reduced in the patients group. The analysis showed that compared with normal control group,the patients with traumatic coma had significantly decreased functional connectivity（ P〈0. 05）. Conclusion： The default mode network may exist in patients with traumatic coma during resting state,but the range was reduced（ P〈0. 05）. Compared with normal control group,patients with traumatic coma showed significant decrease of functional connectivity in multiple brain regions in the resting state,which suggested that the mechanism of traumatic coma is not only associated with brain function network,but also associated with all brain.（ P〈0. 05）.