复发缓解型多发性硬化患者扣带皮层结构和灌注变化

Structural and perfusion changes of cingulate cortex in patients with relapsing-remitting multiple sclerosis

目的观察复发缓解型多发性硬化(RRMS)患者扣带皮层各亚区结构和灌注改变及其与认知评分的相关性,探讨扣带皮层亚区结构及灌注改变对RRMS患者认知功能的影响。方法对28例RRMS患者(MS组)和28名健康对照者(对照组)采集头颅3D-T1WI和3D伪连续动脉自旋标记(3D pCASL)序列图像,并进行认知评分;比较2组间双侧扣带皮层8个亚区皮层厚度和脑血流量(CBF),分析MRI参数与认知评分之间的相关性。结果相比对照组,MS组左侧前扣带皮层尾部、左侧和右侧扣带皮层峡部及后扣带皮层CBF值均减低(t=-2.28、-2.95、-2.13、-2.66、-2.04,P均<0.05),左侧和右侧扣带皮层峡部及左侧后扣带皮层变薄,右侧前扣带皮层喙部皮层厚度值增高(t=-3.01、-3.05、-2.41、2.07,P均<0.05);且认知评分均减低(P均<0.01)。MS组认知评分与扣带皮层部分亚区CBF值及皮层厚度存在相关性(P均<0.05)。结论RRMS患者扣带皮层部分亚区出现的萎缩和灌注改变可能导致认知功能损害。

Objective To observe the changes of structure and perfusion of cingulate cortex in relapsing-remitting multiple sclerosis(RRMS)patients and the relative correlation with cognitive scores,and to explore the impacts of changes of the subarea of cingulate cortex on the cognitive function of RRMS patients.Methods Totally 28 RRMS patients(MS group)and 28 healthy controls(control group)underwent brain MR scanning with 3D-T1W and 3D pseudo-continuous arterial spin labeling(3D pCASL)sequences,and all subjects were cognitively scored.The cortical thickness and cerebral blood flow(CBF)values of 8 sub-regions of cingulate cortex were measured and compared between 2 groups,respectively.The correlations of MRI measurements and cognitive scores were analyzed.Results Compared with control group,CBF in the left anterior caudal of cingulate cortex,left and right isthmus of cingulate cortex and posterior cingulate cortex decreased(t=-2.28,-2.95,-2.13,-2.66,-2.04,all P<0.05),the left and right isthmus left posterior of cingulate cortex became thinner,and the right rostral anterior cingulate cortex increased in MS group(t=-3.01,-3.05,-2.41,2.07,all P<0.05).The cognitive scores of RRMS patients decreased(all P<0.01),which were correlated with CBF value and cortical thickness of some sub-regions of the cingulate cortex(all P<0.05).Conclusion Atrophy and perfusion changes occurred in some subregions of the cingulate cortex in RRMS patients,which might lead to cognitive impairment.