基于静息态fMRI原发性闭角型青光眼的百分比波动振幅研究

Percent amplitude of fluctuation study in primary angle-closure glaucoma based on resting-state fMRI

目的 使用静息态功能磁共振成像(resting-state functional magnetic resonance imaging, rs-fMRI)技术研究原发性闭角型青光眼(primary angle-closure glaucoma, PACG)患者在静息状态下百分比波动振幅(percent amplitude of fluctuation, PerAF)的变化。材料与方法 共纳入江西省人民医院眼科诊断的PACG患者31例。同期,31名性别、年龄、受教育时间与之匹配的健康对照(healthy control, HC)被纳入对照组。对每个受试者进行全脑rs-fMRI扫描,以收集PerAF信号。分别采用单样本t检验和双样本t检验比较各组组内和组间PerAF数据。结果 与HC组相比,PACG患者组在左侧额上回背外侧(t=-3.9421,P<0.001)、眶部(t=-3.4619,P<0.001),左侧眶部额中回(t=-3.6709,P<0.001),右侧额中回(t=-3.8257,P<0.001),右侧额下回三角部(t=-3.6708,t=-4.0375,P<0.001);左侧缘上回(t=-3.9570,P<0.001)、顶下缘角回(t=-3.8230,t=-3.8730,P<0.001),右侧顶上回(t=-4.4581,P<0.001)、中央后回(t=-3.7825,P<0.001),中央旁小叶(t=-4.0816,P<0.001);右侧颞中回(t=-3.8402,P<0.001);左侧舌回(t=-3.5758,P<0.001);左侧前扣带和旁扣带脑回(t=-3.4718,P<0.001)、补充运动区(t=-3.7209,P<0.001)以及右侧小脑下部7b区(t=-3.9479,P<0.001)的PerAF均显著降低(体素水平P<0.001,聚类水平P<0.05,高斯随机场校正)。结论 PACG患者在多个大脑区域存在异常的PerAF值,涉及与视觉、情绪和认知调节相关的初级和高级视觉皮层和大脑区域。

Objective:To study the changes of percentage fluctuation amplitude(PerAF)in patients with primary angle-closure glaucoma(PACG)at rest using resting-state functional magnetic resonance imaging(rs-fMRI)technique.Materials and Methods:A total of 31 cases of PACG patients diagnosed in the ophthalmology department of Jiangxi Provincial People's Hospital were included.During the same period,31 sex,age,and duration of education-matched healthy controls(HC)were included in the control group.Whole-brain rs-fMRI scans were performed on each subject to collect PerAF signals.One-sample t-test and two-sample t-test were used to compare PerAF data across and between groups,respectively.Results:Compared with HC group,subjects in the PACG patient group had significantly lower PerAF in the left supraparietal gyrus(t=-3.9421,P<0.001),orbital(t=-3.4619,P<0.001),left orbital median frontal gyrus(t=-3.6709,P<0.001),bilateral right median frontal gyrus(t=-3.8257,P<0.001),right inferior frontal gyrus deltoid(t=-3.6708,t=-4.0375,P<0.001);left supramarginal gyrus(t=-3.9570,P<0.001),inferior parietal marginal angular gyrus(t=-3.8230,t=-3.8730,P<0.001),right superior parietal gyrus(t=-4.4581,P<0.001),postcentral gyrus(t=-3.7825,P<0.001),and paracentral lobule(t=-4.0816,P<0.001);right middle temporal gyrus(t=-3.8402,P<0.001);left lingual gyrus(t=-3.5758,P<0.001);left anterior cingulate and paracingulate cingulate gyrus(t=-3.4718,P<0.001),supplementary motor area(t=-3.7209,P<0.001),and right inferior cerebellar area 7b(t=-3.9479,P<0.001)(P<0.001 at voxel level,P<0.05 at cluster level,Gaussian random field corrected).Conclusions:Patients with PACG have abnormal PerAF values in multiple brain regions involving primary and higher visual cortex and brain regions associated with visual,emotional,and cognitive regulation.