基于静息态杏仁核亚区功能连接观察高压氧治疗对TBI患者认知功能障碍的影响

Effect of Hyperbaric Oxygen Therapy on Cognitive Dysfunction in Patients with Traumatic Brain Injury Based on Functional Connection of Resting Amygdala Subregions

目的基于静息态杏仁核亚区功能连接观察高压氧治疗对创伤性脑损伤(TBI)患者认知功能障碍的影响.方法将61例行高压氧治疗和61例行非高压氧治疗的TBI患者分为高压氧组和对照组,比较两组患者治疗效果.采用酶联免疫吸附实验测定两组患者血清S100-B、神经元特异性烯醇化酶(NSE)、血清髓鞘碱性蛋白(MBP)水平;采用简易精神状态量表(MMSE)和蒙特利尔认知评估量表(MoCA)对两组患者治疗前后的认知功能进行评价;观察患者治疗前后的杏仁核亚区功能连接情况.结果治疗后,高压氧组认知功能及总有效率高于对照组(P<0.05);神经元特异性烯醇化酶(NSE)、血清髓鞘碱性蛋白(MBP)及血清S100-B水平则低于对照组(P<0.05);左侧杏仁核右侧眶部额下回(ROIFG)、右侧脑岛(RINS)、右侧背外侧额上回(RDSFG)、左侧前扣带和旁扣带脑回(LACG)、右侧杏仁核左侧岛盖部额下回(LOPIFG)、左侧脑岛(LINS)分别与MMSE评分、MoCA评分呈明显的正相关关系,分别与MBP、NSE、S100-B呈明显的负相关关系(P<0.05),右侧杏仁核左侧背外侧额上回(LDSFG)、右侧内侧额上回(RMSFG)分别与MMSE评分、MoCA评分呈明显的负相关关系,分别与MBP、NSE、S100-B呈明显的正相关关系(P<0.05).结论TBI后发生认知功能障碍的患者通过高压氧治疗后可得到有效改善,可能与促进杏仁核亚区的功能连接有关.

Objective To study the effect of hyperbaric oxygen therapy on cognitive impairment in patients with traumatic brain injury(TBI)based on the functional connection of resting amygdala subregion.Method The hyperbaric oxygen group and the control group were treated with hyperbaric oxygen therapy and non-hyperbaric oxygen therapy,61 cases in each group,and the treatment effect was compared between the two groups.The serum levels of S100-B,neuron-specific enolase(NSE)and myelin basic protein(MBP)in the two groups were determined by enzyme-linked immunosorbent assay.The mini-Mental State Scale(MMSE)and Montreal Cognitive Assessment Scale(MoCA)were used to evaluate the cognitive function of the two groups before and after treatment.The functional connectivity of amygdala subregion was observed before and after treatment.Results After treatment,the cognitive function and total effective rate of hyperbaric oxygen group were higher than those of control group(P<0.05).The levels of neuron-specific enolase(NSE),serum myelin basic protein(MBP)and serum S100-B were lower than those of the control group(P<0.05).The right orbital inferior frontal gyrus(ROIFG),right insula(RINS),right dorsolateral superior frontal gyrus(RDSFG),left anterior cingulate and paracingulate gyrus(LACG),right left insula opercularis inferior frontal gyrus(LOPIFG)and left insula(LINS)of the left amygdala were positively correlated with MMSE score and MoCA score,respectively,were negatively correlated with MBP,NSE and S100-B,respectively(P<0.05).The left dorsolateral superior frontal gyrus(LDSFG)and right medial superior frontal gyrus(RMSFG)of the right amygdala were negatively correlated with MMSE score and MoCA score,respectively.It was positively correlated with MBP,NSE and S100-B,respectively(P<0.05).Conclusion Patients with cognitive dysfunction after TBI can be effectively improved by hyper-baric oxygen therapy,which may be related to the promotion of functional connectivity in amygdala subregion.