缺氧缺血性脑病新生儿大脑静息态网络功能属性变化的初步研究

Primary comparative study on the functional properties of cerebral resting state networks in neonates with hypoxic ischemic encephalopathy

目的探讨不同程度缺氧缺血性脑病新生儿大脑静息态网络功能属性。方法使用静息态功能磁共振概率纤维追踪和图论方法对12例轻度缺氧缺血性脑病（hypoxic ischemic encephalopathy，HIE）患儿（轻度组）和14例中重度HIE患儿（中重度组）的大脑静息态网络全局和局部功能属性进行对比研究。结果（1）全局拓扑属性方面，两组患儿大脑均具有小世界属性（轻度组：γ=2．450±1．642，λ=1．542±0．564；中重度组：γ=2．331±1．554，λ=1．353±0．672，符合小世界特征γ〉1且λ≈1）。（2）局部拓扑属性方面，中重度组枢纽区有8个，轻度组枢纽区有14个；在左岛盖、左缘上回、左右颞极和右颞中回，两组节点效率差异有统计学意义（中重度组分别是0．4089±0．0865、0．3377±0．1223、0．3842±0．0898、0．3508±0．1295、0．3564±0．0843，轻度组分别是0．4801±0．0762、0．4465±0．0898、0．4655±0．0812、0．4640±0．0690、0．4271±0．0636，均P〈0．05）。结论中、重度缺氧缺血性脑病患儿大脑静息态功能网络拓扑结构较轻度患儿明显落后，可能与后期语言，运动和认知功能异常有关。

Objective To explore the functional properties of the brain＇ s resting state networks in neonates with hypoxic ischemic encephalopathy. Methods Use the methods of functional MRI probabilistic tractography and graph theory to compare the global and local functional properties of the brain＇ s resting state network between 12 cases of children with mild HIE and 14 cases of children with moderate/severe HIE. Results In terms of global topological properties, both the mild and moderate/severe group showed small-world properties. The γ and λ in the mild group were 2.450±1. 642 and 1. 542±0. 564 and in the moderate/severe group were 2.331 ± 1. 554 and 1. 353 ±0. 672, respectively, which were in line with the characteristics of small-world properties （ γ〉 1 and λ≈1 ）. As far as local topological properties were concerned, the distribution of hub regions in the functional networks had smaller number of nodes in the moderate/severe group （ 8 nodes） than the mild group （ 14 nodes）. The comparison of nodal efficiencies showed that the moderate/severe group had significantly reduced nodal efficiency in the left insula opercula, left supramarginal gyrus, left and right temporal pole and right middle temporal gyrus （the nodal efficiencies of the moderate/severe group ：0.4089±0. 0865,0. 3377±0. 1223, 0. 3842±0. 0898, 0. 3508±0. 1295,0. 3564±0. 0843 ; the nodal efficiencies of the mild group ：0. 4801±0. 0762,0. 4465±0. 0898,0. 4655±0. 0812,0. 4640±0. 0690, 0. 4271±0. 0636,all P〈0.05）. Conclusion The topological structure of resting state functional network in children with moderate and severe hypoxie-ischemic encephalopathy is obviously backward than that in children with mild hypoxic-ischemic encephalopathy,which may be related to abnormal language,movement and cognitive function in the late stage.