基于静息态功能磁共振成像技术探讨成人弱视的中枢机制

Probe of the central mechanism of adult patients with amblyopia based on rs-fMRI technique

目的 应用静息态功能磁共振成像(resting-state functional magnetic resonance imaging, rs-fMRI)分析方法探讨成人弱视的中枢机制。材料与方法 前瞻性招募2021年2月至2022年1月就诊于中日友好医院21例成人弱视患者及22例与其年龄、性别及受教育程度相匹配的健康对照(healthy controls, HC)为研究对象,采集最佳矫正视力、立体视等,进行焦虑及抑郁自评量表评分,同时rs-fMRI数据,使用DPARSF软件对数据进行预处理,分析两组间局部一致性(regional homogeneity,ReHo)及低频振幅分数(fractional amplitude of low-frequency fluctuation, fALFF)的差异;并将差异脑区ReHo值、fALFF值与临床资料进行相关性分析。结果 成人弱视患者右侧颞上回fALFF值降低,而右侧角回fALFF值升高,右侧梭状回及枕叶舌回ReHo值升高(簇水平P<0.01);在单眼弱视患者中,左侧弱视者双侧梭状回及左侧距状裂皮质fALFF值显著高于HC组(簇水平P<0.05),双侧梭状回ReHo值升高(簇水平P<0.05);右侧弱视者的右侧颞上回fALFF值降低、右侧额中回fALFF值升高(簇水平P<0.01);而差异脑区影像学指标与量表评分未见显著相关性(P>0.05)。结论 成人弱视患者的中枢机制中,枕、颞叶皮质区域激活及ReHo改变可能参与了视力损害的视觉信息处理功能代偿过程,可进一步揭示成人弱视的中枢机制。

Objective: To explore the central mechanism of adult patients with amblyopia by resting state-functional magnetic resonance imaging(rs-fMRI). Materials and Methods: We recruited 21 adult patients with amblyopia and 22 healthy controls(HC) group matched with age, sex and education as subjects. Clinical data including best corrected visual acuity, stereopsis, self-rating anxiety and depression scale were performed. Meanwhile, rs-fMRI was collected and preprocessed with DPARSF software. The difference of regional homogeneity(ReHo) and fractional amplitude of low-frequency fluctuation(fALFF) between the two groups and the correlation between ReHo, fALFF and clinical data in changed brain regions were analyzed. Results: In all recruited adult patients with amblyopic, fALFF value of right superior temporal gyrus decreased, while fALFF of right angular gyrus increased(cluster level, P<0.01). ReHo value of right fusiform gyrus and lingual gyrus of occipital lobe increased. What’s more, fALFF of bilateral fusiform gyrus and left calcarine fissure in left-sided amblyopic patients significantly increased(cluster level, P<0.05). ReHo of bilateral fusiform gyrus also increased(cluster level, P<0.05). fALFF of right superior temporal gyrus decreased and right middle frontal gyrus increased in right-sided patients(cluster level, P<0.01). These values in the differential brain regions did not correlate significantly with Self-Rating Anxiety Scale(SAS) and Self-Rating Depression Scale(SDS) scores. Conclusions: In the central mechanism of adult patients with amblyopia, the activation and ReHo changes in occipital and temporal cortex may be involved in the functional compensation of visual information processing caused by visual impairment, which helps to further reveal the central mechanism of adult amblyopia.