心律失常射频消融术后焦虑状态患者的静息态MRI低频振幅分析

Analysis of amplitude of low-frequency fluctuation in patients with anxiety after radiofrequency catheter ablation by resting state fMRI

目的采用低频振幅(ALFF)观察心律失常射频消融术后出现焦虑状态患者的全脑功能活动。方法收集符合纳入标准的26例心律失常射频消融术(RFCA)后焦虑状态患者作为RFCA组,纳入同期年龄、性别相匹配的26名健康志愿者作为正常对照组,2组均行fMRI,对2组有差异脑区的ALFF进行双样本t检验,提取有差异的脑区与汉密尔顿焦虑量表评分进行偏相关分析。结果与正常对照组相比,RFCA组左侧颞中回、右侧壳核、左侧杏仁核ALFF增高,左侧前额叶背外侧皮层(DLPFC)、右侧楔前叶、左侧额中叶、右侧枕中叶ALFF减低差异有统计学意义(Alphasim校正,P<0.01)。左侧DLPFC的ALFF值与HAMA评分呈负相关(r=-0.872,P=0.013)。结论心律失常射频消融术后焦虑状态患者在静息状态下存在脑功能的异常,ALFF有助于为该疾病的发病机制提供更多证据。

Objective To observe brain functional activity of patients with arrhythmia after radiofrequency ablation with amplitude of low-frequency fluctuation （ALFF）. Methods Twenty-six patients with anxiety disorder after radiofrequency catheter ablation （RFCA） were included as RFCA group. Age and sex matched twenty six healthy volunteers were included as control group. The difference of ALFF between the two groups was analyzed by two sample t test. Partial correlation between extracted values from dysfunctional brain regions and hamilton anxiety scale （HAMA） scores were investigated. Results Compared with control group, ALFF of left middle temporal gyrus, right putamen, left amygdala significantly in- creased, and left dorsolateral prefrontal cortex （DLPFC）, right praecuneus, left middle frontal gyrus and right middle oc- cipital gyus significantly decreased in RFCA group （Alphasirn correction, P〈0.01 ）. ALFF values of left DI.PFC were negatively correlated with HAMA scores （r= 0. 872, P=0. 013）. Conclusion The brain activity of RFCA patients in resting state is abnormal. ALFF can provide more evidences for the pathogenesis of the disease.