眼睑痉挛患者静息态功能磁共振分数低频振幅的研究

Amplitude of low-frequency oscillations in blepharospasm： a resting-state functional MRI study

目的 研究眼睑痉挛患者静息态下脑功能活动与健康对照组的差异，探讨眼睑痉挛的发病机制。方法 收集24例眼睑痉挛患者和24名健康对照，采用两样本t检验比较两组间功能磁共振分数低频振幅的差异，将患者差异脑区的分数低频振幅算法（fractional amplitude of low-frequency fluctuation，fALFF）值分别与眼睑痉挛程度、焦虑自评量表（SAS）及抑郁自评量表（SDS）评分结果进行相关分析。结果 眼睑痉挛组fALFF值升高脑区主要位于左侧中央后回、双侧辅助运动区及左侧小脑前叶，而双侧内侧额上回、双侧内侧和旁扣带回、右侧角回、双侧楔前叶fALFF值低于健康对照组（t＝-5.2495～5.3675，均P〈0.01，高斯随机理论的多重比较校正）。眼睑痉挛患者中，差异脑区fALFF值与眼睑痉挛程度、SAS及SDS评分无相关性。结论 感觉及辅助运动区的异常及小脑、默认网络均直接或间接参与眼睑痉挛的发病。

Objective To explore the possible pathophysiology of blepharospasm by comparing differences of brain functional activities between patients with blepharospasm and healthy controls with the resting-state functional magnetic resonance imaging （fMRI）. Methods Twenty-four patients with blepharospasm and 24 age- and sex-matched healthy controls were enrolled in the study. The fractional amplitude of low-frequency fluctuation （fALFF） method was used to analyze the data. Two-sample t test was applied to compare differences of fALFF between patients with blepharospasm and healthy controls. Pearson correlation was used to examine the correlation between the fALFF values in brain regions with abnormal fALFF and symptom severity of blepharospasm, anxiety, and depression in patients. Results The whole brain analysis indicated that patients with blepharospasm had siguificanfly increased fALFF in the left postcentral gyrus, bilateral supplementary motor area, left cerebellum anterior lobe and significantly decreased fALFF in the bilateral superior medial frontal gyrus, bilateral middle eingulum, right angular gyrus, bilateral preeuneus compared with healthy controls （ t = - 5. 2495 - 5. 3675, all P 〈 0. 01 ）. There was no significant correlation between abnormal fALFF and symptom severity of blepharospasm, anxiety, and depression in patients. Conclusion Dysfunction of the sensational and supplementary motor area, cerebellum and defanlt-mode network may underlie the pathophysiology of blepharospasm.