呼吸睡眠暂停低通气患者脑功能的功能性MRI诊断

Functional magnetic resonance imaging in obstructive sleep apnea hypopnea syndrome patients before and after continuous positive airway pressure treatment

目的:探讨静息状态下呼吸睡眠暂停低通气(OSAHS)患者脑功能是否发生异常及经持续正压通气(CAPP)治疗后脑功能的改变情况。方法:搜集25例中重度OSAHS患者(患者组)及25例健康志愿者(对照组)。患者CAPP治疗前后及健康志愿者均进行MRI平扫及血氧依赖水平功能性磁共振成像(BOLD-fMRI)检查。结果:与对照组相比,患者组治疗前右侧额中回等脑区的局部一致性减低,右侧岛叶等脑区的低频振幅(ALFF)值减低,右侧额下回等脑区的低频振幅比率(fALFF)值减低。与对照组相比,患者组治疗后右侧小脑半球等脑区的局部一致性减低,右侧楔叶等脑区的ALFF减低,右侧额下回等脑区的fALFF减低。与治疗前相比,患者组治疗后右侧颞下回等脑区的局部一致性明显增高,右侧小脑半球等脑区的ALFF增高,左侧枕中回等脑区的fALFF增高。结论:静息状态下OSAHS患者脑功能状态存在异常,经CAPP治疗后脑功能异常的脑区可部分逆转。功能性MRI对呼吸睡眠暂停低通气患者脑功能的诊断具有重要价值。

Objective：To study if there is any brain functional abnormality in obstructive sleep apnea hypopnea syndrome（OSAHS）during resting-state,as well as the changes of brain function after continuous positive airway pressure（CPAP）treatment.Methods：Twenty-five patients with moderate or serious OSAHS（study group）and 25 healthy volunteers（control group）were recruited.Conventional MR and resting state BOLD-fMR examination before and after CPAP treatment in patients group as well as in control group were performed.Results：Compared with the control group,decreased ReHo in the right middle frontal gyrus etc.reduced ALFF in right cerebellum etc,and reduced fALFF in right inferior frontal gyrus etc.were observed in OSAHS patients before treatment.Reduced ReHo in the right cerebellum etc.decreased ALFF in the Right cuneus etc.and decreased fALFF in right inferior frontal gyrus etc.were found in OSAHS patients after treatment when compared with the control group.In OSAHS patients after treatment,ReHo increased in right inferior temporal gyrus etc.ALFF increased in right cerebellar hemisphere etc and fALFF increased in left middle occipital gyrus etc.could be revealed when compared with that before treatment.Conclusion：Resting-state brain dysfunction was observed in OSAHS patients,and brain dysfunction were partially reversed after effective CPAP treatment.