糖尿病视网膜病变患者自发活动性异常的脑区与MoCA的相关性研究

Abnormal Spontaneous Brain Activity and the Correlation with MoCA in Patients with Diabetic Retinopathy

目的基于静息态功能磁共振局部一致性技术探讨糖尿病视网膜病变患者局部脑区一致性的改变及与认知关系。方法选择27例糖尿病视网膜病变(DR)及与之年龄、性别、受教育年限相匹配的单纯糖尿病(N-DR)患者27例,均进行实验室检查、蒙特利尔量表(MoCA)检测及头颅磁共振扫描。利用多元回归分析及Pearson回归分析观察临床变量与活动性异常活动脑区ReHo值之间的关系。结果相对于N-DR,DR患者在左小脑后叶、右额叶/额中回/内侧回、右枕叶/楔叶/距状回、左颞叶/上/中回、右边缘叶/后扣带回、左顶叶/中央后回ReHo值降低;在左额叶/眶部额上回、左顶叶/楔前叶ReHo值增强。而且MoCA量表评分与颞叶及楔前叶异常活动的脑区存在相关性。降低的枕叶距状回及颞叶中回与糖化血红蛋白呈负相关,增强的眶额叶与糖化血红蛋白呈正相关。结论糖尿病视网膜病变患者存在多个脑区活动性异常的表现,且这些局部异常活动的脑区与认知功能及糖化血红蛋白存在相关。

Objective To explore the altered spontaneous cerebral activity patterns and the relationship with cognitive function in patients with diabetic retinopathy （DR） using resting-state functional magnetic resonance imaging （rs-fMRI） based on the regional homogeneity. Methods Patients with DR（ n = 27 ）and age-, gender-, and education- matched non- diabetic retinopathy control subjects （ N- DR, n = 27 ） were prospectively studied. All individuals underwent a laboratory neuropsychological test and fMRI scan. The relationships between ReHo values and clinical measurements were analysed using a multiple and Pearson regression analysis. Results Compared to the N-DR, the DR group showed significantly decreased ReHo values in the left cerebellum posterior lobe, right cerebrum//frontal lobe//middle//medial frontal gyrus, right occipital lobe//cuneus// calcarine, left temporal lobe//superior//middle temporal gyrus, fight limbic lobe//posterior cingulate, left parietal lobe//postcentral gyrus. Increased values in the left frontal lobe//superior frontal gyrus//medial// orbital gyrus,right left cerebrum//parietal lobe//precuneus. Furthermore, MoCA scores were correlated with altered spontaneous cerebral activity in temporal lobe and precuneus. While decreased ReHo values in the occipital calcarine lobe and middle temporal gyrus were found to be negatively and in frontal orbital gyrus positively correlated with glycosylated haemoglobin （HbA1 c） levels. Conclusion Multiple brain regions showed significant altered in the spontaneous neuronal activity synchronicity in T2DM patients. Meanwhile, those were associated with cognitive function and HbAlc levels.