rs-fMRI评估焦虑对老年轻度认知功能障碍的价值

Rs-fMRI used to assess the effects of anxiety on mild cognitive function of elder population

目的探讨静息态功能磁共振成像(rs-fMRI)评估焦虑对老年人轻度认知功能障碍的价值。方法本研究纳入15例轻度认知功能障碍(MCI)伴焦虑患者(MCI+)、29例MCI不伴焦虑患者(MCI-)及21名健康老年人(NC)为研究对象。所有受试者均要求完成全套神经心理学量表评估及rs-fMRI扫描。对比分析3组及MCI+组与MCI-两组间神经心理学量表评分及低频振幅(ALFF)的差异,并计算差异脑区的ALFF值与神经心理学量表评分间的相关系数。结果3组简易精神状态检测量表(MMSE)、蒙特利尔认知评估量表基础版、听觉词语学习测验华山版(AVLT-H)长时延迟回忆(N5)和再认(N7)、波士顿命名测试以及形状连线测验(STT)A&B部分的评分存在显著统计学差异(均P<0.05)。两两比较结果显示,MCI+组的MMSE、AVLT-H N7评分明显高于MCI-组(P<0.05)。3组被试左侧枕下回、右侧顶上小叶的ALFF值存在统计学差异(P<0.05)。与MCI-组比较,MCI+组的ALFF值在左侧楔前叶、左侧后扣带回、左侧颞上回及右侧内侧额上回显著降低;在右侧顶下小叶、右侧顶上小叶显著增高(P<0.05)。MCI+组的右侧顶下小叶的ALFF值与STT-B呈显著负相关。结论MCI+患者的认知功能损害更明显,尤其体现在总体认知功能和记忆功能。MCI+患者在焦虑相关脑区的自发神经活动及功能连接均已出现功能影像学异常表现,这些表现可能与其神经病理学机制有关,rs-fMRI评估焦虑对老年轻度认知功能障碍具有重要临床价值。

Objective To investigate the effect of anxiety on mild cognitive function of elder population by using resting-state functional magnetic resonance imaging.Methods 15 mild cognitive impairment(MCI)patients with anxiety(MCI+),29 MCI patients without anxiety(MCI-)and 21 normal control(NC)were enrolled in this study.Each participant required to complete a set of systematic neuropsychological assessments and rs-fMRI acquisition.The differences in neuropsychological scale and amplitude of low-frequency fluctuation(ALFF)among the three groups and between the MCI+and the MCI-groups were calculated.Furthermore,the correlation coefficient between ALFF value and neuropsychological scale score were analyzed and calculated.Results Significant differences were found among three groups in the scores of the Mini-mental State Examination(MMSE),Montreal Cognitive Assessment Basic,delayed recall scores(N5)and recognition scores(N7)of Auditory Verb Learn Test-Huashan Version(AVLT-H),Boston Naming Testing(BNT)and Shape Trails Test(STT)A&B.The MMSE and AVLT-H N7 scores in MCI+group were significantly higher than those in MCI-group.The ALFF results showed that the ALFF values of the left inferior occipital gyrus and the right superior parietal lobule were significantly different among the three groups.Compared with the MCI-group,the ALFF in the MCI+group was significantly decreased in the left precuneus,left posterior cingulate cortex,left superior temporal gyrus,and right medial superior frontal gyrus;which was significantly increased in the right inferior parietal lobule and the right superior parietal lobule.Correlation analysis showed that the ALFF values of the right inferior parietal lobule in the MCI+group were significantly negatively correlated with STT-B scores.Conclusion Compared with the MCI-patients,MCI+patients have worse cognitive function,especially in terms of overall cognitive function and memory function.The abnormal spontaneous neural activity and functional connections of anxiety-related brain regions in MCI+patients may be related to their neuropathological mechanism.