医学生中慢性疲劳综合征患者的功能磁共振ReHo特征研究

The ReHo of rs-fMRI Features for Chronic Fatigue Syndrome in Medical Students

目的通过静息态脑功能磁共振(rs-fMRI)技术采集脑功能数据,利用局部一致性(ReHo)分析方法,探讨医学生群体中慢性疲劳综合征(CFS)患者与健康对照人群之间的脑功能差异,及其与临床症状的相关性。方法从在读医学研究生中招募健康被试20名和符合CFS诊断的患病被试20例,对所有被试进行临床症状对应的量表评价和脑功能MRI检查,对比健康被试与CFS患者之间不同的脑功能激活状态,发现差异脑区,将差异脑区的ReHo强度值与临床症状量表评分结果进行相关性分析。结果与对照组对比,CFS组在右侧丘脑和旁扣带脑回出现ReHo增高,而在双侧的颞中回出现ReHo降低。CFS组ReHo增高脑区的强度值与临床症状量表评分存在相关性,其中右侧丘脑与疲劳量表-14(FS-14)评分存在正相关(r=0.7128,P=0.0004),与症状自评量表(SCL-90)评分存在正相关(r=0.4303,P=0.0498),与匹兹堡睡眠质量指数量表(PSQI)结果存在正相关(r=0.4924,P=0.0274),右侧旁扣带脑回与蒙特利尔认知评估量表(MoCA)评分存在负相关(r=-0.4510,P=0.0460),而ReHo降低的脑区与临床量表评分无明显相关。结论ReHo分析发现,相较于健康对照组,CFS患者边缘系统、基底节区等有异常激活状态出现,CFS患者脑功能ReHo存在明显差异,涉及到的脑区与情感、感觉、觉醒-睡眠、记忆任务有关,且与临床症状存在明显相关性。

Objective To collect brain function data by rs fMRI technology,and use ReHo method to explore the differ-ences in brain function between medical students with CFS and healthy control,and its correlation with clinical symptoms.Methods 20 healthy subjects and 20 patients with CFS are recruited from medical graduate students.All subjects are e-valuated by the scale corresponding to clinical symptoms and examined by fMRI scanning.Different activation states of brain function were compared between healthy subjects and patients with CFS.Different brain regions were found.Correla-tion analysis is conducted between ReHo values of different brain regions and clinical symptom scale scores.Results Compared with the normal group,in the CFS group,ReHo increased in the right thalamus and paracingulate gyrus,and de-creased in the bilateral middle temporal gyrus.In the CFS group,the value of ReHo increased in the brain region was corre-lated with the score of the clinical symptom scale.There was a positive correlation between the right thalamus and the FS-14 score(r=0.7128,P=0.0004),a positive correlation with the SCL-90 score(r=0.4303,P=0.0498),a positive cor-relation with the PSQI score(r=0.4924,P=0.0274),and a negative correlation between the right paracingulate gyrus and the MoCa score(r=-0.4510,P=0.0460).However,the decreased brain area of ReHo had no significant correlation with the clinical scale score.Conclusion ReHo analysis found that,compared with the healthy control group,CFS patients had abnormal activation in the limbic system,basal ganglia and other areas.There are significant differences in brain function ReHo in CFS patients.The involved brain areas are related to emotional,sensory,arousal and memory tasks,and are signifi-cantly related to clinical symptoms.