突发性聋患者治疗前后在大脑皮层静息态fMRI的表现

Cortical Resting State fMRI in Patients with Sudden Deafness before and after Treatment

目的探讨突发性耳聋(SSNHL)患者治疗前后在大脑皮层静息态fMRI的表现。方法选取2021年10月-2023年9月在上饶市人民医院耳鼻咽喉科收治的150例SSNHL患者作为研究对象,所有患者进行周期为20 d的治疗,统计患者临床疗效情况,并计算总有效率;分别于治疗前3 d及治疗结束后进行2次fMRI扫描,比较有效患者和无效患者治疗前后的fMRI变化。结果治疗后痊愈患者59例、显效50例、有效19例、无效22例,临床总有效率为85.33%(128/150)。有效患者治疗前后ALFF信号存在差异,其中治疗后ALFF信号升高脑区为左侧额中回、右侧颞下回、左侧眶部额上回、左侧背外侧额上内侧回、右侧海马旁回及右侧前扣带和旁扣带脑回,信号降低脑区有左侧颞中回、左侧颞上回及右侧楔叶、右侧补充运动区,差异有统计学意义(P<0.05)。无效患者治疗前后fMRI差异变化主要发生于颞上、中、下回,治疗后,颞下回ALFF信号升高,颞中回及颞上回ALFF信号降低,治疗前后差异存在统计学意义(P<0.05)。结论有效和无效SSNHL患者治疗前后的静息态fMRI信息会在不同脑区发生改变,相应的发生不同脑区的激活,为评估SSNHL疗效提供有力的参考价值。

Objective To investigate the cerebral cortical resting state fMRI in patients with sudden deafness(SSNHL)before and after treatment.Methods 150 patients with SSNHL admitted to the Otolaryngology Department of Shangrao People's Hospital from October 2021 to September 2023 were selected as the research objects.All patients underwent peripheral therapy for 20 days.The clinical efficacy of the patients was analyzed and the total effective rate was calculated.Two fMRI scans were performed 3 days before and after treatment,respectively,to compare the fMRI changes of effective patients and ineffective patients before and after treatment.Results After treatment,59 patients were cured,50 were effective,19 were effective,and 22 were ineffective.The total clinical effective rate was 85.33%(128/150).There were differences in ALFF signals in effective patients before and after treatment.After treatment,ALFF signals increased in the left middle frontal gyrus,right inferior temporal gyrus,left orbital superior frontal gyrus,left dorsolateral superior frontal medial gyrus,right parahippocampal gyrus,right anterior cingulate and paracingulate gyrus,and decreased in the left middle temporal gyrus,left superior temporal gyrus,right cuneus,and right supplementary motor area.The difference was statistically significant(P<0.05).The differences in fMRI of ineffective patients before and after treatment mainly occurred in superior temporal,middle and inferior gyrus.After treatment,ALFF signal of inferior temporal gyrus increased,while ALFF signal of middle temporal gyrus and superior temporal gyrus decreased,with statistical significance before and after treatment(P<0.05).Conclusion The resting state fMRI information of patients with effective and ineffective SSNHL before and after treatment will be changed in different brain regions,and corresponding activation will occur in different brain regions,providing a strong reference value for evaluating the efficacy of SSNHL.