基于VBM研究中度至重度COPD患者脑灰质体积变化

Study of gray matter volume changes in patients with moderate to severe COPD based on voxel-based morphological analysis

目的探讨基于VBM研究中度至重度慢性阻塞性肺疾病(COPD)患者脑灰质体积变化。方法收集中度至重度COPD患者60例和55例性别、年龄、受教育程度、BMI与之相匹配的健康志愿者作为对照组,比较两组间肺功能、动脉血气分析指标及MoCA评分,采集两组被试高分辨率3D-T 1WI结构像MRI数据,运用VBM软件分析两组脑灰质体积的差异。结果共40例COPD患者及40例健康志愿者纳入最终分析。COPD组FVC、FVC%预计值、FEV 1、FEV 1%预计值、FEV 1/FVC比值均低于对照组,COPD组MoCA评分明显低于HC组,视空间与执行功能、注意、抽象、延迟记忆评分差异有统计学意义(P值均<0.05)。VBM分析显示,与HC组相比,COPD组灰质体积降低的脑区为双侧颞中回、右侧枕中回、右侧额下回、双侧缘上回、左侧额中回、左侧中央前回、左侧楔前叶;灰质体积增加的脑区为双侧纹状体(P值均<0.005)。而且,COPD组部分灰质异常与肺功能、动脉血气分析指标、MoCA评分相关。结论稳定期COPD患者存在多个脑区灰质体积的异常,部分灰质体积的变化与肺功能、动脉血气分析及神经认知评分相关,这些发现可能为COPD脑功能研究提供新的见解。

Objective To evaluate Grey matter (GM) volume changes in patients with COPD who were evaluated using voxel-based morphological analysis (VBM). Methods Sixty patients with moderate to severe COPD and 48 age-, gender-, education-, and BMI-matched healthy controls (HCs) were enrolled into this study. The data of arterial blood gas, lung function and cognitive function were acquired for all subjects. All subjects underwent high-resolution 3D T 1WI structures MR scanning. Differences in gray matter volume between the two groups were analyzed using VBM software. Results Total of forty COPD and forty HC subjects were included into the final analyses. The FVC, predicted values of FVC%, FEV 1, predicted values of FEV 1%, and the ratio of FEV 1/FVC were lower than those in HC group. The MoCA score of COPD group was significantly lower than that of HC group, and the difference of visual space and executive function, attention, abstraction and delayed memory score was statistically significant (all P <0.05). VBM revealed decreased grey matter volume in thebilateral middle temporal gyrus, right occipital gyrus, right inferior frontal gyrus, bilateral marginal superior gyrus, left frontal median/superior gyrus, left central anterior gyrus, left precuneus. The brain volume with increased GM located in the bilateral striatum (all P <0.005). Moreover, gray matter abnormalities in the COPD group were associated withpulmonary function, and arterial blood gas index, and MoCA score. Conclusion Abnormalities of GM volume in various brain regions were found in stable COPD, and volume changes of several brain regions were associated with lung function, arterial blood gas analysis, and neurocognitive scores. These findings may provide new insights into the brain function research of COPD.