基于ReHo和fALFF的优势半球与非优势半球基底节区脑梗死后运动障碍的静息态脑功能成像研究

Study of resting-state fMRI based on ReHo and fALFF in patients with motor dysfunction after dominant and non-dominant hemispheres basal ganglia cerebral infarction

目的:采用静息态fMRI技术联合局部一致性(ReHo)和比率低频振幅(fALFF)探讨优势半球与非优势半球基底节区脑梗死后运动障碍患者的脑局部自发活动变化。方法:招募20例基底节区脑梗死后运动障碍患者,按照病灶位置分为优势半球脑梗死组11例和非优势半球脑梗死组9例;招募18例性别、年龄匹配的健康志愿者(对照组)分别行静息态fMRI,利用基于MATLAB的SPM12和DPARSF软件对数据进行分析,采用双样本t检验(体素水平P<0.01,团块水平P<0.05,GRF校正)对3组受试者的ReHo及fALFF脑图行组间两两比较,提取差异脑区的ReHo值及fALFF值。结果:与对照组相比,优势半球脑梗死组左侧三角部额下回的ReHo值显著升高(t=4.97,P<0.05),左侧扣带回白质的fALFF值显著降低(t=-7.57,P<0.05)。与对照组相比,非优势半球脑梗死组左侧额中回的ReHo值显著升高(t=6.01,P<0.05),左侧内侧和旁扣带脑回(t=-6.02,P<0.05)、右侧枕上回(t=-5.25,P<0.05)的ReHo值显著降低,右侧眶部额下回(t=5.01,P<0.05)、左侧枕中回(t=4.74,P<0.05)的fALFF值显著升高,右侧内侧和旁扣带脑回fALFF值显著降低(t=-5.58,P<0.05)。与非优势半球脑梗死组相比,优势半球脑梗死组左侧小脑的ReHo值显著升高(t=4.51,P<0.05),左侧三角部额下回(t=5.29,P<0.05)、左侧舌回(t=5.63,P<0.05)、左侧额中回(t=6.72,P<0.05)的fALFF值显著升高。结论:静息状态下,与对照组相比,优势半球与非优势半球基底节区脑梗死后双侧大脑皮质运动、感觉及认知等多个脑区神经元活动发生变化;与非优势半球脑梗死相比,优势半球脑梗死能更快地出现代偿性激活,增强神经元活动,这一发现可能有助于进一步理解不同半球间基底节区脑梗死后运动障碍患者的大脑局部神经影像学差异。

Objective:To investigate the local spontaneous activity changes of regional homogeneity(ReHo)and fraction amplitude of low-frequency fluctuation(fALFF)by resting-state fMRI(rs-fMRI)in patients with motor dysfunction after dominant and non-dominant hemispheres basal ganglia cerebral infarction.Methods:Rs-fMRI was performed on 20 patients with motor dysfunction after basal ganglia cerebral infarction who were divided into dominant hemisphere cerebral infarction group(DHCI group,11 cases)and non-dominant hemisphere cerebral infarction group(NDHCI group,9 cases)according to the lesion location.At the same time,18 healthy controls(the control group)underwent rs-fMRI.Data were processed and analyzed using the SPM12 and DPARSF toolboxs based on MATLAB,and the two-sample t-test(voxel level P<0.01,cluster level P<0.05,corrected by GRF)was used to compare the ReHo and fALFF brain maps between groups.The ReHo and fALFF values were extracted from the differential brain regions.Results:Compared with the control group,ReHo value of left triangular inferior frontal gyrus increased and the fALFF value of the left cingulate gyrus white matter decreased significantly in DHCI group(both P<0.05).Compared with the control group,the brain areas with increased ReHo value in NDHCI group included the left middle frontal gyrus(t=6.01,P<0.05),with decreased ReHo value included the left median cingulate and paracingulate gyrus(t=-6.02,P<0.05)and the right superior occipital gyrus(t=-5.25,P<0.05);and the brain areas with increased fALFF value included the right orbital inferior frontal gyrus(t=5.01,P<0.05)and left middle occipital gyrus(t=4.74,P<0.05),with decreased fALFF value included the right median cingulate and paracingulate gyrus(t=-5.58,P<0.05).Compared with NDHCI group,the brain areas with increased ReHo value in DHCI group included left cerebellum(t=4.51,P<0.05),with increased fALFF value included left triangular inferior frontal gyrus(t=5.29,P<0.05),left lingual gyrus(t=5.63,P<0.05),left middle frontal gyrus(t=6.72,P<0.05).Conclusions:In the resting state,neuronal activities in bilateral cortical motor,sensory and cognitive areas were changed after basal ganglia cerebral infarction in DHCI and NDHCI patients compared with healthy controls.Meanwhile,DHCI can show faster compensatory activation and enhance neuronal activity compared with NDHCI,which may contribute to further understanding of the regional neuroimaging differences in patients with motor dysfunction after basal ganglia cerebral infarction between different hemispheres.