基于局部一致性分析方法研究原发性开角型青光眼患者脑区异常激活及认知改变

Tract based regional homogeneity method in exploration on changes of abnormal brain activation and cognitive in primary open angle glaucoma patients

目的采用静息态功能磁共振成像(rs-fMRI)评价原发性开角型青光眼(POAG)患者脑部局部一致性(ReHo)和认知状态的改变。方法对22例POAG患者(POAG组)及25例健康志愿者(NC组)行MR扫描前均接受简易精神状态检查(MMSE)量表评估并记录得分,计算全脑ReHo值,并进行统计学分析。结果与NC组相比,POAG组右侧背侧前扣带回、双侧额内上回、双侧额内侧回以及右侧小脑前叶区域(P<0.05)ReHo值明显升高;左侧距状沟、右侧距状沟/舌回、双侧中央前/后回、左侧小脑后叶、双侧楔前叶及左侧顶下叶(P<0.05)Re Ho值明显减低。POAG组MMSE评分与额内侧回(r=0.451,P=0.016)的ReHo值存在明显正相关。结论 POAG患者在静息状态下视觉、眼压及认知处理等多个功能脑区存在局部一致性改变,为POAG的病理生理学研究提供了影像支持,并有可能为POAG的精准治疗揭示新的靶点。

Objective To explore the changes of brain regional homogeneity （ReHo） and cognitive status in primary open angle glaucoma patients. Methods 22 POAG patients （POAG group） and 25 healthy volunteer （normal control group） were evaluated with mini-mental state examination （MMSE） before MR examination, the whole brain ReHo value was calculated, and statistical analysis was performed. Results Compared to normal control group, POAG group showed the increased ReHo （ P 〈0.05） in the right dorsal anterior cingulate, the bilateral medial frontal gyrus, the bilateral medial frontal gyrus, the right anterior lobe of cerebellum, and the decreased ReHo （ P 〈0.05） in the left lateral sulcus, the right lateral sulcus / lingual gyrus, the bilateral anterior / posterior, the left posterior lobe, the bilateral anterior lobe, the left lower lobe. Significant positive correlations were found between the ReHo values and MMSE scores in medial frontal gyrus （ r =0.451, P =0.016） of POAG group. Conclusion POAG patients combine ReHo abnormal changes of multiple functional brain regions in the visual intraocular pressure and cognitive processing, which is provided image support for the pathophysiology research of POAG, and revealed new targets for the accurate treatment of POAG.