轻度血管性认知障碍脑网络功能连接改变及其与认知功能的相关性

Changes of whole-brain functional connectivity in mild vascular cognitive impairment and correlations with cognitive function

目的 观察轻度血管性认知障碍(mVCI)患者全脑种子点-种子点功能连接(FC)改变,分析其与认知功能的关系。方法 对77例临床确诊mVCI患者(mVCI组)及78名认知功能正常的老年健康志愿者(对照组)行蒙特利尔认知评估(MoCA)量表评分,采集静息态功能MRI(rs-fMRI);比较组间MoCA评分差异,采用种子点到种子点(ROI-to-ROI)FC分析方法观察2组全脑FC差异,分析mVCI组与对照组存在差异脑区的FC与MoCA评分的相关性。结果 mVCI组MoCA评分[20.0(18.0,24.0)]低于对照组[27.5(27.0,29.0),P<0.01],患者额顶颞叶及壳核、苍白球等多个脑区组成的26条ROI-to-ROI的FC降低(FDR校正P均<0.05);其左、右壳核与右顶盖(r=0.31、0.25,P=0.01、0.03),右辅助运动区与左、右顶盖(r均=0.27,P均=0.02),右辅助运动区、左苍白球与右中央盖(r=0.29、0.26,P=0.01、0.03)间FC均与MoCA评分呈正相关。结论 mVCI患者纹状体-额顶叶皮质FC广泛对称性下降,且FC改变与其认知功能呈正相关。

Objective To explore changes of whole-brain functional connectivity(FC) in mild vascular cognitive impairment(mVCI) patients and correlations with cognitive function. Methods Seventy-seven patients with clinically confirmed mVCI(mVCI group) and 78 matched elderly volunteers with normal cognitive function(control group) underwent Montreal cognitive assessment(MoCA) score and resting-state functional MRI(rs-fMRI). MoCA scores were compared between groups, the whole brain FC were observed with ROI-to-ROI FC analysis method and compared between groups, while the correlations of FC in brain regions being different between groups and MoCA scores in mVCI group were analyzed. Results MoCA scores in mVCI group(20.0 [18.0, 24.0]) were lower than in control group(27.5 [27.0, 29.0], P<0.01). In mVCI group, FC of 26 ROI-to-ROI composed of brain regions including the frontoparietal temporal lobe, shell nucleus and pallidum decreased(all FDR correction P<0.05), and FC of the left and right shell nucleus-right parietal lobe(r=0.31, 0.25, P=0.01, 0.03), right supplementary motor area-left and right parietal lobe(both r=0.27, both P=0.02), right supplementary motor area, left pallidum and right central lid(r=0.29, 0.26, P=0.01, 0.03) were positively correlated with MoCA scores. Conclusion FC of striato-frontoparietal cortex in mVCI patients decreased widely and symmetrically, and the changes of FC were positively correlated with cognitive function.