视神经脊髓炎谱系疾病患者大脑半球间动态镜像同伦功能连接的静态功能MR研究

A static functional MR study of dynamic voxel-mirrored homotopic connectivity between cerebral hemispheres in patients with neuromyelitis optica spectrum disease

目的探讨水通道蛋白4(AQP4)抗体阳性的视神经脊髓炎谱系疾病(NMOSD)患者大脑半球间动态镜像同伦功能连接(dVMHC)的改变。方法采用病例对照研究设计。连续纳入2015年1月至2019年12月解放军总医院神经眼科就诊的21例AQP4抗体阳性的NMOSD患者。同期纳入性别、年龄和教育程度相匹配的34名健康对照者。应用静态功能MR(rs-fMRI)进行检查,提取大脑半球间dVMHC值。两组dVMHC数据的组内比较采用单样本t检验、组间比较采用双样本t检验。结果与健康对照组相比,AQP4抗体阳性的NMOSD患者双侧小脑前叶(顶部t=3.9096)、双侧枕叶(梭状回t=3.6674)、小脑后叶(右侧小脑蚓部6区t=3.3174、双侧小脑山坡和小脑6区t=3.5760)、右侧边缘叶(Brodmann 23区t=3.7969)dVMHC值明显增高,差异均有统计学意义(P<0.05)。结论AQP4抗体阳性的NMOSD患者在小脑、枕中回(MOG)和后扣带回(PCG)显示出大量异常的功能连接(FC),表明dVMHC可以评估NMOSD患者的运动和认知功能改变,帮助理解NMOSD发作后大脑半球间的功能改变。

Objective To investigate the alterations of dynamic voxel-mirrored homotopic connectivity(dVMHC)between the cerebral hemispheres in patients who are in aquaporin-4 antibody(AQP4)seropositive with neuromyelitis optica spectrum disorders(NMOSD).Methods A case-control study design was used.Twenty-one NMOSD patients with seropositive AQP4-Ab were enrolled from January 2015 to December 2019 in PLA General Hospital.Thirty-four healthy controls(HC)matched for age,sex and education were recruited during the same period.Each subject underwent a whole‐brain rs-fMRI scan to detect the interhemispheric dVMHC value.The intra‐and inter‐group comparisons of two sets of dVMHC values were conducted using a one‐sample t‐test and two‐sample t‐test.Results Compared with the HC group,the AQP4 antibody-positive NMOSD patients with the bilateral cerebellum anterior lobe/culmen(on the top,t=3.9096),bilateral occipital lobe(fusiform,t=3.6674),cerebellum posterior lobe(right vermis 6,t=3.3174,bilateral declive and cerebellum 6 L,t=3.5760),right limbic lobe(Brodmann area 23,t=3.7969)had significantly higher dVMHC values,and all differences were statistically significant(P<0.05).Conclusion AQP4-positive patients with NMOSD showed a large number of abnormal functional connectivity(FC)in the cerebellum regions,middle occipital gyrus(MOG),and posterior cingulate gyrus(PCG),suggesting that dVMHC could assess altered motor and cognitive function in NMOSD patients and understand the interhemispheric function changes after NMOSD episodes.