分数低频振幅技术对非增生性糖尿病视网膜病变患者静息态脑功能改变的评估

Changes of brain function in resting-state in patients with nonproliferative diabetic retinopathy assessed by fractional low-frequency amplitude technique

目的利用静息态功能磁共振成像(rs-fMRI)的分数低频振幅(fALFF)技术研究糖尿病视网膜病变(DR)患者的静息态脑功能改变。方法采用横断面研究方法,收集2018年7月至2019年3月于武汉大学人民医院就诊的34例非增生性DR患者为DR组,同期于当地社区招募34名年龄、性别、受教育程度相匹配的健康志愿者为正常对照组。所有受检者均接受常规MRI和rs-fMRI检查,计算全脑fALFF值,比较2个组受检者不同脑区fALFF测定值。结果 DR组患者左侧颞叶下回、左侧小脑区、右侧苍白球、左侧辅助运动区和右侧眶额叶上回fALFF值分别为-0.58±0.29、-0.47±0.39、-0.37±0.24、-0.31±0.26和0.29±0.49,均明显高于正常对照组的-1.03±0.29、-0.90±0.31、-0.78±0.22、-0.72±0.21和-0.17±0.46,差异均有统计学意义(体素水平P<0.01,高斯随机场校正,聚类水平P<0.05)(均P<0.001)。结论 DR患者存在多个脑区的神经元活动异常,包括左侧颞叶下回、左侧小脑区、右侧苍白球、左侧辅助运动区和右侧眶额叶上回。这些异常神经元活动区域可能与认知、视觉、情绪等方面的功能有关。

Objective To study the changes of brain function in patients with diabetic retinopathy(DR)by using resting-state functional magnetic resonance imaging(rs-fMRI)based on the fractional amplitude of low-frequency fluctuation(fALFF)method.Methods A cross-sectional study method was performed,34 cases of non-proliferative DR patients treated in the Renmin Hospital of Wuhan University during July 2018 to March 2019 were collected.Meanwhile,34 healthy volunteers with matched age,gender,and education years were recruited.All subjects were performed with conventional MRI scanning and rs-fMRI scanning,then the fALFF values in the whole brain were calculated,and the differences of neuronal activities between the two groups were explored.This research protocol was approved by the Ethic Committee of Renmin Hospital of Wuhan University,and written informed consent was obtained from each subject before any medical examination.Results The fALFF values of DR patients in the left inferior temporal gyrus,left cerebellum,right pallidum,left supplementary motor area,and right superior orbitofrontal gyrus were-0.58±0.29,-0.47±0.39,-0.37±0.24,-0.31±0.26 and 0.29±0.49,respectively,which were significantly higher than-1.03±0.29,-0.90±0.31,-0.78±0.22,-0.72±0.21 and-0.17±0.46 of the normal control(voxel level P<0.01,gaussian random field correction,cluster level P<0.05)(all at P<0.001).Conclusions Abnormal spontaneous neuronal activities occur in the left inferior temporal gyrus,left cerebellum,right pallidum,left supplementary motor area,and right superior orbitofrontal gyrus of DR patients.These abnormalities may associate with cognitive,vision and emotion.