单侧突发性聋患者rs-fMRI低频振幅和局部一致性研究

Amplitude of low-frequency fluctuation and regional homogeneity of rs-fMRI in patients with unilateral sudden sensorineural hearing loss

目的利用静息态功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)技术低频振幅(amplitude of low-frequency fluctuation,ALFF)和局部一致性(regional homogeneity,ReHo)的方法探讨单侧突发性聋患者急性期内静息态脑活动的变化。材料与方法选取单侧突发性聋急性期患者23例和健康对照者18例(健康对照组),进行rs-fMRI扫描,采用ALFF、ReHo两种方法分析患者内在脑活动水平的改变,并提取差异有统计学意义的脑区与临床数据进行相关性分析。结果与健康对照组相比,患者ALFF值增高的脑区有同侧颞中回、脑岛、缘上回和对侧额下回,ALFF值降低的脑区有对侧梭状回、颞中回、中央后回(P<0.001)。ReHo增高的脑区有对侧小脑下叶及同侧颞中回、额中回,减低的脑区有同侧枕上回及对侧额中回(P<0.001)。相关性分析显示,患者同侧颞中回、缘上回ALFF值与纯音测听(Pure Tone Audiometry,PTA)和简易智力状况检查(Mini-Mental State Examination,MMSE)评分呈正相关(P<0.05),左侧颞中回ReHo值与PTA结果呈正相关,左侧额中回ReHo值与MMSE评分呈正相关(P<0.05);左侧枕上回ReHo值与抑郁自评量表(Self-rating Depression Scale,SDS)评分呈正相关(P<0.05)。结论单侧突发性聋患者存在听觉与非听觉的某些脑区脑功能活动的改变,涉及默认网络、突显网络和视听觉网络三个主要网络,可能与突发性聋的发病有关。

Objective:To explore the patients with unilateral sudden sensorineural hearing loss(SSNHL)at the acute stage using resting-state functional magnetic resonance imaging(rs-f MRI)technique with amplitude of low-frequency fluctuation(ALFF)and regional homogeneity(Re Ho).Materials and Methods:A total of 23 patients with unilateral SSNHL at the acute stage and 18 matched healthy controls were selected for rs-fMRI scanning.ALFF and ReHo methods were used to analyze the changes of internal brain activity in patients with unilateral SSNHL,and the correlation between ALFF and ReHo values of brain regions with statistically significant differences and clinical correlation scores were analyzed.Results:Compared with the healthy control group,the ALFF value of patients with unilateral SSNHL increased in ipsilateral middle temporal gyrus,insula,superior marginal gyrus and contralateral inferior frontal gyrus,while decreased in contralateral fusiform gyrus,middle temporal gyrus and posterior central gyrus(P<0.001).Re Ho increased in the contralateral inferior cerebellar lobe,ipsilateral middle temporal gyrus and middle frontal gyrus,while decreased in ipsilateral superior occipital gyrus and contralateral middle frontal gyrus(P<0.001).ALFF values of ipsilateral middle temporal gyrus and superior marginal gyrus were positively correlated with Pure Tone Audiometry(PTA)and Mini-Mental State Examination(MMSE)scores(P<0.05).The Re Ho value of the left middle temporal gyrus was positively correlated with PTA results,and the ReHo value of the left middle frontal gyrus was positively correlated with MMSE score(P<0.05).There was a positive correlation between the Re Ho value of left occipital loop and Self-rating Depression Scale(SDS)score(P<0.05).Conclusions:In the patients with unilateral SSNHL in resting state,there are different degree of brain functional activity changes in auditory and non-auditory parts,mainly involving default network,prominent network and visual and auditory network,which may be related to the pathogenesis of SSNHL.