原发性闭角型青光眼患者丘脑—皮层通路的静息态fMRI功能连接

Functional connectivity of thalamo-cortical pathway in primary angle-closure glaucoma using resting state fMRI

目的利用静息态fMRI技术,探讨原发性闭角型青光眼(PACG)患者丘脑—皮层通路功能连接的变化。方法25例PACG患者(PACG组)和22名性别与年龄匹配的健康志愿者(对照组)均接受静息态fMRI。将双侧丘脑的各7个亚区作为ROI,分别为初级运动、感觉、枕叶、前额叶、前运动、后顶叶及颞叶丘脑ROI,与全脑皮层体素作静息态fMRI功能连接分析,并进行组间两独立样本t检验。结果与对照组比较,PACG组丘脑与视觉传导通路(顶叶/楔前叶、额叶/额下回)及非视觉传导通路(中央旁小叶、中央后回、边缘叶/海马旁回)功能连接减低,丘脑与视觉传导通路(枕叶、顶叶/顶下小叶、颞叶/颞下回)以及非视觉传导通路(小脑前叶/山顶)功能连接增加。结论 PACG患者存在包括丘脑视觉传导通路及非视觉传导通路的连接异常,提示丘脑在PACG患者神经学发病机制中起着重要作用。

Objective To investigate the functional dysconnectivity of thalamo-cortex pathways by using resting state fMRI（rs-fMRI）in primary angle-closure glaucoma（PACG）patients.Methods All of the 25 PACG patients（PACG group）and 22 age and gender matched healthy volunteers（control group）underwent rs-fMRI scans.Each side of thalamus was parcelled into 7ROIs which corresponded to primary motor,primary and secondary somatosensory,occipital,prefrontal,premotor,posterior parietal,and temporal thalamic.The functional connectivity between the ROIs and the whole brain voxels were analyzed.The differences between the two groups were compared by independent two-sample t-test.ResultsThe decreased functional connectivities were found between the thalamic ROIs and visual pathways（parietal lobe/precuneus,frontal lobe/inferior frontal gyrus）,the thalamic ROIs and nonvisual pathways（paracentral lobule,postcentral gyru,limbic lobe/hippocampus）in PACG group.The increased functional connectivities were found between thalamic ROIs and visual pathways（occipital lobe,parietal lobe/inferior parietal lobe,temporal lobe/inferior temporal gyrus）,thalamic ROIs and nonvisual pathways（anterior lobe of cerebellum/cuneus）in PACG group compared with control group.Conclusion In PACG patients,there are abnormalities in functional connectivity of thalamic ROIs and visual/nonvisual pathways,which indicate that thalamus plays an important role in the neurological pathogenesis of PACG.