首次发作的视神经炎患者初级视觉皮层功能连接的异常改变

Altered functional connectivity of primary visual cortex in optic neuritis patients with first episode

目的应用静息态功能磁共振成像(functional magnetic resonance imaging,f MRI)分析首次发作的视神经炎(acute optic neuritis,ON)患者初级视觉皮层(primary visual cortex,V1)的功能连接变化,并探讨其临床意义。方法收集51例临床确诊的急性视神经炎及50例性别、年龄匹配的健康志愿者,获取静息态f MRI数据及临床信息。应用统计参数图(SPM5)进行数据后处理,选择初级视觉皮层为种子点,分析ON患者与健康志愿者V1区与全脑其他脑区功能连接的情况,比较两组数据间的差异。将ON患者的视力、病程及认知功能评分(PASAT)与功能连接异常的脑区进行相关性分析。结果与正常对照组相比,视神经炎患者枕叶舌回与V1的功能连接明显减低,扣带回、右侧缘上回、右侧楔前叶、左侧顶下小叶及右侧岛叶与V1的功能连接明显增强,且差异均具有统计学意义(均为P<0.01)。ON患者PASAT评分与右枕叶舌回、右额上回和右额叶内侧回的功能连接异常呈正相关。结论静息态f MRI能检测到首次发作的ON患者V1区与视觉相关脑区功能连接的减低,以及默认网络的代偿性活动,为临床探索疾病的早期损害提供客观依据。

Objective To investigate the functional connectivity changes of primary visual cortex in acute optic neuritis （ ON） patients with first episode by resting-state functional magnetic resonance imaging （ fMRI）.Methods Resting-state fMRIs and neuro-ophthalmologic assessments were collected from 51 single-episode ON patients and 50 age-and sex-matched healthy controls （HCs）.We chose the primary visual cortex （V1） as the region of interest, and mapped all brain regions that are functionally connected to it using SPM5.The group differences of the functional connectivity of V 1 were compared among the two groups .The relationships between the vision , disease duration and Paced Auditory Serial Addition Test （ PASAT） scores and regions with al-tered functional connectivity in ON patients were further explored .Results Compared to HCs , ON patients showed a decreased functional connectivity between V 1 and the lingual gyrus , and increased functional connectivity between V 1 and the cingulate gy-rus, right supramarginal gyrus , right precuneus, left inferior parietal lobule and right insula （ P 〈0.01）.In ON patients, there was a significant correlation between PASAT and functional changes in right lingual gyrus , right medial and superior frontal gyrus . Conclusion fMRI can detect functional disconnection （ between V1 and vision related regions ） and reorganization coexists in ON patients with first episode , which provide evidence of brain damage in the early-stage of this disease .