一氧化碳中毒后迟发性脑病的磁共振体素镜像同伦连接研究

Altered Voxel-Mirrored Homotopic Connectivity in Delayed Encephalopathy After Carbonmonoxide Poisoning:A Resting-State f MRI Study

目的应用静息态功能磁共振成像(rs-fMRI)观察一氧化碳(CO)中毒后迟发性脑病(DEACMP)患者大脑体素镜像同伦连接的变化,探讨DEACMP相关脑损伤神经影像学机制。方法对22例DEACMP患者和22例性别、年龄及教育程度相匹配的健康志愿者进行颅脑rs-fMRI扫描,并进行镜像同伦连接(VMHC)分析,采用两独立样本t检验进行组间比较,探讨差异脑区半球间功能连接状态,并与临床特征做相关性分析。再将差异脑区作为种子区,与全脑体素做功能连接(FC)分析。结果与健康对照组对比,DEACMP患者双侧楔叶、双侧舌回的VMHC值增高。以上述脑区做种子点与全脑做功能连接分析发现,DEACMP患者的左侧楔叶与小脑后叶功能连接增强;右侧楔叶与右侧中央后回、右侧顶上小叶、右侧缘上回、右侧角回功能连接降低;左侧舌回与小脑前叶功能连接增强;右侧舌回与左侧小脑半球功能连接增强。结论DEACMP患者的部分脑区大脑半球间功能连接增强,提示DEACMP患者双侧大脑半球间同伦连接性改变,这些脑区与全脑其他脑区功能连接出现异常,这可能为分析DEACMP的神经病理机制提供影像学依据。

Objective To investigate neuropathologic mechanisms in functional brain regions in patients with delayed encephalopathy after carbon monoxide poisoning(DEACMP)by the alterations of interhemispheric functional connectivity using resting-state functional magnetic resonance imaging(rs-fMRI).Methods 22 patients with DEACMP and 22 age-,sex-and education-matched healthy controls(HCs)were recruited and rs-fMRI scans were performed.Voxel-mirrored homotopic connectivity(VMHC)was used for analyzing interhemispheric functional connectivity of functional magnetic resonance imaging(fMRI)data and the seed-based functional connectivity was calculated.We thencompared thedifferences between the two groups.Correlationanalysis was then finally performed between VMHC and clinical characteristics.Results Compared with the HCs,the DEACMP patients displayed significantly increased VMHC values in the bilateral cuneus and lingual gyrus than healthy controls.The FC between the left cuneus and the cerebellar posterior lobe was enhanced in DEACMP patients.FCbetween the right cuneus,the right posterior central gyrus,the right parietal lobe,the right superior margin gyrus,and the right cingulargyrus wasreduced.The FC between left lingual gyrus and anterior cerebellar lobe was enhanced.The FC between the right lingual gyrus and the left cerebellar hemisphere were enhanced.Conclusion Patients with DEACMP demonstrated abnormal interhemispheric functional connectivity which may indicate the neuropathologic mechanisms and cognitive function changes of DEACMP.