基于功能磁共振的原发性开角型青光眼患者脑部变化的分析

Study of brain changes in patients with primary open-angle Glaucoma based on functional magnetic resonance imaging

目的通过VBM和TBSS技术,观察原发性开角型青光眼(POAG)患者脑灰质体积和白质完整性的变化;分析视网膜神经纤维层(RNFL)厚度、神经节细胞层(GCC)厚度、视野平均缺损(MD)、视野指数(VFI)与全脑灰质和白质的相关性。方法选取18例POAG患者为实验组,18例年龄、性别、受教育程度相匹配的健康受试者为对照组,分别行功能磁共振、光学相干断层扫描、视野检查,运用VBM和TBSS技术,观察两组的差异脑区。结果(1)VBM:两组GM体积差异脑区在左舌回,代表该区域灰质体积减少;(2)TBSS:两组FA值差异脑区位于:左胼胝体膝部、右胼胝体体部、右皮质脊髓束、右后放射冠,表示该区域白质完整性发生显著改变。RD值差异脑区位于:左前放射冠,右前放射冠、右后放射冠、右胼胝体体部,表示该区域髓鞘完整性发生显著改变;(3)GCC与全脑灰质体积做相基于功能磁共振的原发性开角型青光眼患者脑部变化的研究相关。结论(1)两组VBM分析显示差异脑区在左舌回,与GCC、VFI、MD做全脑相关的结果基本趋于一致;(2)TBSS分析显示FA值差异脑区位于:左胼胝体膝部、右胼胝体体部、右皮质脊髓束、右后放射冠,RD值差异脑区位于:左前放射冠,右前放射冠、右后放射冠、右胼胝体体部。

Objective To observe the changes of gray matter volume and white matter integrity in patients with primary open Angle glaucoma(POAG)by VBM and TBSS and to analyze the correlation between the thickness of retinal nerve fiber layer(RNFL)ganglion cell layer(GCC)and the visual field mean deviation(MD)visual field indices(VFI)of the whole brain gray matter and white matter.Methods Eighteen patients with POAG were selected as the experimental group,and eighteen healthy subjects matched in age,gender and education level were selected as the control group to undergo functional magnetic resonance,optical coherence tomography,visual field examination respectively.VBM and TBSS were used to observe the different brain regions between the two groups.Results (1)VBM:The difference in GM volume between the two groups was found in the left lingual gyrus,which indicated that the gray matter volume in this region decreased;(2)TBSS:The brain regions with different FA values were located left genu of corpus callosum,right body of corpus callosum,right corticospinal tract,right posterior corona radiata between the two groups,indicating significant changes in the integrity of white matter in this region.The brain regions with different RD values were located in the left anterior corona radiata,right posterior corona radiata,right anterior corona radiata and right body of corpus callosum,indicating significant changes in myelin integrity in this region;(3)Correlation analysis of GCC and total gray matter volume showed that it was significantly positively correlated with left putamen,VFI and MD were significantly positively correlated with left occipital lobe.Conclusion (1)VBM analysis of the two groups showed that the different brain regions were in the left lingual gyrus,and the results of whole brain correlation with GCC,VFI,MD were basically consistent;(2)TBSS analysis showed that the brain regions with FA value difference were located in left genu of corpus callosum,right body of corpus callosum,right corticospinal tract,right posterior corona radiata;RD value difference was located in left anterior corona radiata,right posterior corona radiata,right anterior corona radiata and right body of corpus callosum.