采用fMRI研究感音聋儿相关脑区的ALFF及ReHo改变

Study of ALFF and Reho in the brain regions of deaf children by fMRI change

目的探讨采用静息态功能磁共振研究0~4岁的双侧先天性重度感音神经性耳聋患儿听觉、语言、视觉及其他相关脑区的ALFF值及ReHo的变化情况,判断人工耳蜗置入前患儿的听觉、语言、视觉及其他有关脑区的功能重塑。方法选取0~4岁双侧先天性重度感音神经性耳聋患儿25例,正常听力组20例,以2岁为大脑发育的关键期分为4组:0~2岁耳聋组患儿16例、0~2岁对照组9例;2~4岁耳聋组患儿9例、2~4岁对照组11例。采用GE3.0T磁共振成像仪对被试者进行静息态功能磁共振扫描,分别采用低频振幅(ALFF)、局部一致性(ReHo)分析静息态功能磁共振数据。结果0~2岁耳聋患儿与0~2岁正常被试的ALFF及ReHo相比、2~4岁耳聋患儿与2~4岁正常被试的ALFF及ReHo相比、2~4岁耳聋患儿和0~2岁耳聋患者的ALFF及ReHo相比差值均有统计学意义(P≤0.005)。结论低频振幅及局部一致性能较好地揭示双侧先天性重度感音神经性耳聋患儿大脑异常神经活动造成的BOLD信号的改变,0~4岁的双侧感音性聋儿的听觉、视觉、语言及其他感觉系统相关皮层可能发生了功能重塑,功能磁共振对人工耳蜗术前评估及预后的判断提供一定的帮助。

Objective To study the changes of ALFF and ReHo in hearing,language,vision and other related brain regions in children with bilateral congenital severe sensorineural deafness aged 0~4 years old by resting functional magnetic resonance(fMRI),and to judge the functional remodeling of hearing,language,vision and other related brain regions in children before cochlear implantation.Methods Twenty-five children aged 0~4 years with bilateral congenital severe sensorineural deafness were enrolled.Twenty children in the normal hearing group were divided into four groups 16 children aged 0~2 years old with deafness,9 children aged 0~2 years old with control group,9 children aged 2~4 years old with deafness and 11 children aged 2~4 years old with control group.Resting-state functional magnetic resonance(fmr)scans were performed with GE 3.0 T magnetic resonance imager in deaf and normal groups,and resting-state fMR data were analyzed with low-frequency amplitude(ALFF)and local consistency(ReHo).Results Compared with ALFF of normal subjects aged 0 to 2 years,ALFF increased in the left anterior cuneiform lobe,right superior frontal gyrus,right middle occipital gyrus and right parietal lobule,and decreased in the left superior temporal gyrus and left inferior frontal gyrus.The left anterior cingulate gyrus and left infratemporal gyrus were higher in 2~4 year-old deaf subjects than in 2~4 year-old normal subjects.The brain regions with decreased ALFF values were left inferior frontal gyrus and left superior temporal gyrus.Compared with 0~2 years old deaf patients,ALFF increased in left superior temporal gyrus,left inferior frontal gyrus and insula,and decreased in right medial frontal gyrus and left inferior temporal gyrus.Compared with the normal subjects aged 0 to 2 years,the brain regions with increased ReHo were left spindle gyrus,and the brain regions with decreased ReHo were left superior temporal gyrus and left inferior frontal gyrus.Compared with the normal subjects aged 2 to 4 years old,the brain areas with increased ReHo were left anterior cuneiform lobe,right parietal lobule,left suboccipital gyrus and right cuneiform lobe.ReHo decreased in the left superior temporal gyrus and right angular gyrus.The right superior temporal gyrus was higher in deaf patients aged 2 to 4 years than in deaf patients aged 0 to 2 years,and the left medial frontal gyrus was lower in deaf patients aged 2 to 4 years(P≤0.005).Conclusion Low frequency amplitude and local consistency can better reveal the changes of BOLD signal caused by abnormal brain activity in children with bilateral congenital severe sensorineu-ral deafness.Functional remodeling may occur in the auditory,visual,linguistic and other sensory cortex of children aged 0~4 years old with bilateral sensorineural deafness.Functional magnetic resonance imaging can provide preoperative evaluation and prognosis judgement for cochlear implants.