阻塞性睡眠呼吸暂停低通气综合征的脑ReHo和fALFF研究

Study of ReHo and fALFF in patients with obstructive sleep apnea hypopnea syndrome

目的采用局部一致性(regional homogeneity,ReHo)和分数低频振幅(fractional amplitude of low-frequency fluctuation,fALFF)来探索静息状态下阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者脑神经元的活动情况。材料与方法纳入十堰市人民医院呼吸内科经过多导睡眠监测(polysomnography,PSG)初次诊断的OSAHS男性患者30例,选取同时段经PSG监测为睡眠正常、而其他基本情况与OSAHS组相似的志愿者30例为正常对照(normal control,NC)组。所有受试者均进行静息态功能磁共振成像(resting state functional magnetic resonance imaging,rs-fMRI)检查,运用ReHo、fALFF分析将OSAHS组与NC组进行对比,采用两独立样本t检验,找出其明显差异的脑区。结果与NC组相比,OSAHS组的ReHo值、fALFF值差异均有统计学意义(P<0.001,Alphasim校正):(1)ReHo值增加的脑区有左侧脑桥(t=3.94,P<0.001)、左侧小脑前叶(t=4.68,P<0.001)、右侧小脑前叶(t=4.94,P<0.001),全脑无明显ReHo值减低的脑区;(2)fALFF值增高的脑区有左侧小脑后叶(t=6.20,P<0.001)、左侧颞上回(t=5.49,P<0.001)、左侧梭状回(t=4.35,P<0.001),fALFF值减低的脑区有左侧中央旁小叶(t=-4.12,P<0.001)。结论OSAHS患者的多个脑区的脑神经元局部活动一致性、活动幅度均有所改变。OSAHS患者的部分脑区的局部一致性增高,fALFF发生变化的脑区多集中于左侧大脑半球。

Objective:To investigate the brain regions with abnormal neural activity in the patients with obstructive sleep apnea hypopnea syndrome(OSAHS),using regional homogeneity(ReHo)and fractional amplitude of low-frequency fluctuation(fALFF)of the rest-state functional magnetic resonance imaging(rs-fMRI)technique.Materials and Methods:A total of 30 male patients with OSAHS who were initially diagnosed and untreated by polysomnography(PSG)in the Department of Respiratory of Shiyan Renmin Hospital were collected,and 30 volunteers with normal sleep,similar age and education level monitored by PSG during the same period were selected as the normal control(NC)group.Rs-fMRI examination was performed to obtain blood oxygen level dependent(BOLD)signals.ReHo,fALFF are used to compare the OSAHS group with the NC group to find out the brain regions with significant differences.Results:Compared with the NC group,the OSAHS group has significant differences between ReHo and fALFF(P<0.001).The brain regions with increased ReHo value included left pons(t=3.94,P<0.001),left anterior cerebellar lobe(t=4.68,P<0.001)and right anterior cerebellar lobe(t=4.94,P<0.001).The brain region with decreased ReHo value is none.The brain regions with increased fALFF value are left posterior lobe of the cerebellum(t=6.20,P<0.001),left superior temporal gyrus(t=5.49,P<0.001),and left fusiform gyrus(t=4.35,P<0.001).The brain region with decreased fALFF value is left paracentral lobule(t=-4.12,P<0.001).Conclusions:In patients with OSAHS,the ReHo value and the fALFF value in multiple brain regions were changed.The ReHo value of some brain regions in OSAHS patients increased,and the brain regions that fALFF value changed were mostly concentrated in the left cerebral hemisphere.