克罗恩病患者左脑岛及右后顶叶皮层厚度与功能连接异常

Abnormal cortical thickness and functional connectivity of the left insula and right posterior parietal cortex in Crohn's disease

目的从结构和功能两个层面,探讨克罗恩病(Crohn's disease,CD)患者大脑是否存在变化,并分析与焦虑、抑郁评分的关系。材料与方法收集20例CD患者及21例正常对照组大脑结构与静息态功能磁共振影像及临床指标数据。基于Schaefer分区模板,将全脑分为100个脑区,分析脑区皮层厚度是否存在差异。计算结构差异脑区间功能连接(functional connectivity,FC),比较两组间FC是否存在差异。最后,使用皮尔逊相关系数衡量差异脑区皮层厚度和FC与临床指标(焦虑评分、抑郁评分、CD活动指数、病程)的相关性。结果与正常对照组相比,CD组左脑岛(P=0.002,FDR校正)、右后顶叶(P=0.031,FDR校正)皮层厚度下降。与正常对照组相比,CD组左脑岛-右后顶叶间FC显著降低(P=0.025);CD患者左脑岛皮层厚度与抑郁评分存在显著负相关(r=−0.61,P=0.007)。结论CD患者较正常对照左脑岛和右后顶叶皮层结构和FC受损,左脑岛皮层厚度变薄与抑郁评分增加有关,这为理解CD的神经机制提供新的线索。

Objective:To investigate the alterations in brain structure and function among patients with Crohn's disease(CD)and their correlation with clinical indicators.Materials and Methods:Brain structural and resting-state functional magnetic resonance imaging data,along with clinical indicator data,were collected from 20 CD patients and 21 healthy controls.Based on the Schaefer atlas,the left and right hemispheres were divided into 100 brain regions,and the differences in cortical thickness between the two groups were examined.Functional connectivity(FC)was calculated among the brain regions showing significant structural group difference,and the differences in FC between the two groups were compared.The associations between clinical indicators[Self-rating Anxiety Scale(SAS)score,Self-rating Depression Scale(SDS)score,CD activity index and disease duration]and abnormal cortical thickness&FC were measured using Pearson correlation coefficient in CD group.Results:Compared to the healthy control group,CD patients exhibited a decrease in cortical thickness in the left insula(P=0.002,FDR correction)and right posterior parietal cortex(P=0.031,FDR correction).The FC between the left insula and right posterior parietal cortex was significantly reduced in CD group(P=0.025).Furthermore,there was a significant negative correlation between cortical thickness of left insula and SDS score among CD patients(r=−0.61,P=0.007).Conclusions:The left insular and right posterior parietal cortex structure and FC are damaged in CD patients compared with normal controls.The thickness of left insular cortex is associated with the increase of depression score,which provides new clues for understanding the neural mechanism of CD.