经手术和语音康复后非综合征型唇腭裂儿童静息态脑功能改变的磁共振特征

Magnetic resonance imaging characteristics of resting-state brain function in children with nonsyndromic cleft lip and palate after surgical repair and speech rehabilitation

目的:探讨非综合征型唇腭裂(NSCLP)患儿在外科修复术和语音治疗康复后静息状态脑功能模式。方法:选取北京儿童医院和北京口腔医院就诊的28例NSCLP儿童和28例性别和年龄相匹配的健康者(对照组),进行3DT1和静息态功能性磁共振数据采集。使用DPARSFA软件进行预处理并计算低频振幅(ALFF)和局部一致性(ReHo),采用双样本t检验评价组间差异(TFCE校正,P<0.05)。对于有显著性差异脑区的静息态脑功能参数与汉语语言清晰度量表(CLCDS)评分进行相关性分析。结果:NSCLP患儿左颞中回、左枕中回、右楔叶、右楔前叶、左中央后回、左顶上小叶ALFF值明显降低。与对照组相比,ReHo值降低脑区包括左侧的中央后回、中央前回、顶上小叶、缘上回和旁中央小叶。异常脑区的ALFF值和ReHo值与CLCDS评分无显著性相关。结论:经外科修复手术和语音治疗康复后的NSCLP患儿静息态自发性神经元活动及其协调性仍未达到正常水平,且以优势半球的语言相关脑区异常为主。

Objective To explore the resting-state brain functional patterns in pediatric patients with nonsyndromic cleft lip and palate(NSCLP)after surgical repair and speech rehabilitation.Methods A total of 28 pediatric patients with NSCLP treated in Beijing Children's Hospital and Beijing Stomatological Hospital and 28 gender-and age-matched healthy controls were enrolled and examined by 3DT1 and resting-state functional MRI.DPARSFA software was used for preprocessing and calculating the amplitude of low-frequency fluctuations(ALFF)and regional homogeneity(ReHo).Two-sample t-test(TFCE correction,P<0.05)was used for evaluating inter-group differences.In addition,a correlation analysis between the Chinese language clear degree scale(CLCDS)scores and the resting-state properties of brain regions with significant differences in NSCLP children after rehabilitation was carried out.Results For the pediatric patients with NSCLP,decreased ALFF values were detected in the left middle temporal gyrus,left middle occipital gyrus,right cuneus,right precuneus,left postcentral gyrus,left superior parietal lobule,and decreased ReHo values were found in the left postcentral gyrus,left precentral gyrus,left superior parietal lobule,left supramarginal gyrus and left paracentral lobule.There was no significant correlation between the resting-state properties(ALFF value and ReHo value)of brain regions with significant differences and CLCDS scores.Conclusion The spontaneous neuron activities and their coordination of NSCLP children after surgical repair and speech rehabilitation have not yet fully restored to the normal level,and the involved brain regions are mainly related to language in the dominant cerebral hemisphere.