脑静息态功能磁共振局部一致性分析在轻度认知障碍患者中的初步研究

Preliminary study of brain resting state functional magnetic resonance local consistency analysis in patients with mild cognitive impairment

目的利用局部一致性(regional homogeneity,ReHo)分析方法来探讨轻度认知障碍(mild cognitive impairment,MCI)患者局部自发脑活动特点,并进一步探讨相应脑区ReHo值改变与认知功能及临床生理指标的相关性。材料与方法39例被试入组,其中临床诊断的MCI患者17例,年龄、性别及受教育年限相匹配的健康志愿者22例,所有受试者均行静息态功能磁共振成像(resting-state fMRI,rs-fMRI)扫描,采用rs-fMRI的ReHo分析方法,比较静息状态下MCI患者与健康志愿者ReHo值存在差异的脑区,对存在显著差异脑区的ReHo值与认知评估量表及临床生理指标进行相关分析。结果与正常对照比较,MCI组右侧岛叶、左侧小脑半球、旁扣带回、颞下回、左右梭状回ReHo值升高;而左侧颞上回、右侧背外侧额上回ReHo值降低。所有被试蒙特利尔认知评估量表(montreal cognitive assessment scale,MoCA)评分与右侧脑岛区(r=-0.487,P=0.002)ReHo值呈负相关,与左侧颞上回(r=0.610,P<0.001)及右侧背外侧额上回(r=0.475,P=0.002)呈正相关。所有被试简易智能状态检查量表(mini mental status examination,MMSE)评分与左侧小脑上回(r=-0.407,P=0.010)呈负相关,与左侧颞上回(r=0.466,P=0.003)呈正相关。MCI组右侧岛叶ReHo值与血浆果糖胺浓度呈负相关(r=-0.630,P=0.007),左侧小脑半球ReHo值与血清肌酐浓度呈负相关(r=-0.579,P=0.015)。结论轻度认知障碍患者rs-fMRI的ReHo值有明显改变,并与认知功能改变及临床生理指标存在一定的相关性。

Objective:To explore the characteristics of functional brain changes in patients with mild cognitive impairment(MCI)with regional homogeneity(ReHo),and further explore the relationship between the changes of ReHo value of corresponding brain regions and cognitive function and clinical physiological indicators.Materials and Methods:A total of 39 subjects were collected,including 17 MCI patients and 22 healthy volunteers with matching age,gender,and education years.All subjects were subjected to resting-state functional magnetic resonance imaging(rs-fMRI)scan,using the ReHo analysis method,to compare the resting brain area between MCI patients and healthy volunteers in the resting state.Then extract the significant differences in ReHo values of brain regions and cognitive assessment scale and clinical physiological indicators for correlation analysis.Results:Compared with healthy controls,MCI showed significantly decreased ReHo values in right insula/fusiform gyrus,left cerebellar hemisphere/paracingulate cortex/inferior frontal gyrus/fusiform gyrus,while increased ReHo values in left superior temporal gyrus and right superior frontal gyrus.The montreal cognitive assessment scale(MoCA)were inversely correlated with the ReHo values of right insula(r=-0.487,P=0.002),and positively correlated with the ReHo values of left superior temporal gyrus(r=0.610,P<0.001)and right dorsal lateral frontal gyrus(r=0.475,P=0.002)in all subjects.The mini mental status examination(MMSE)were inversely correlated with the Re Ho values of upper left cerebellum(r=-0.407,P=0.010),and positively correlated with the Re Ho values of left superior temporal gyrus(r=0.466,P=0.003)in all subjects.Furthermore,the Re Ho values of right insula were inversely correlated with the fructosamine concentrations in the blood plasma(r=-0.630,P=0.007)and the Re Ho values of left cerebellar hemispherehave negative correlation with serum creatinine concentration(r=-0.579,P=0.015)in MCI.Conclusions:The Re Ho value of rs-f MRI in patients with MCI was significantly changed,and there was a certain correlation with changes in cognitive function and clinical physiological data.