慢性肾精亏损型耳鸣患者的静息态功能磁共振成像研究

Resting-State Functional Magnetic Resonance Imaging of Tinnitus in Patients with Chronic Kidney Essence Deficiency Syndrome

目的观察慢性肾精亏损型耳鸣患者静息态功能磁共振成像的中枢特征,分析其与临床特征的相关性,探讨可能存在的神经影像学机制及意义。方法对我科于2020年8月~2022年12月招募的慢性肾精亏损型耳鸣患者组(92例)以及同时期招募的健康志愿者对照组(91例)完成静息态功能磁共振扫描和临床信息的采集。采用低频振幅(ALFF)分析方法计算得到两组差异脑区,提取ALFF值并与患者临床特征进行相关性分析。此外,计算差异脑区与整个大脑之间的功能连接(FC)结果。结果与健康对照组相比,患者组的双侧楔前叶、左侧后扣带回ALFF值增加,右侧中央前回、右侧中央后回的ALFF值减少。相关性分析显示耳鸣患者组左侧后扣带回的ALFF值与THI评分呈显著正相关(r=0.641,P<0.001);右侧中央前回的ALFF值与SAS评分呈显著负相关(r=-0.601,P<0.001)。将低频振幅发生显著变化的脑区作为感兴趣区,作全脑的功能连接分析,结果显示左侧后扣带回左侧颞中回、左侧枕中回、左侧中央后回功能连接减弱。结论慢性肾精亏损型耳鸣患者多个脑区功能连接强度出现异常,涉及默认网络、边缘系统、听觉网络、视觉网络等脑区。左侧后扣带回、右侧中央前回可能分别成为评估耳鸣严重程度、耳鸣负性情绪方面的神经影像学指标。

Objective To observe the central characteristics of resting functional magnetic resonance imaging(fMRI)in tinnitus patients with chronic kidney essence deficiency syndrome,analyze its correlation with clinical features,and explore the possible neuroimaging mechanism and significance.Methods From August 2020 to December 2022,92 tinnitus patients with chronic kidney essence deficiency syndrome and 91 healthy volunteers recruited in the same period were enrolled in our department to complete rest fMRI scanning and clinical information collection.The different brain regions of the two groups were calculated by low frequency amplitude(ALFF)analysis,and the ALFF values were extracted and correlated with the clinical characteristics of the patients.In addition,the functional connections(FC)between the differential brain regions and the whole brain were calculated.Results Compared with the healthy control group,the ALFF values of bilateral anterior cuneate lobe and left posterior cingulate gyrus increased,while those of right precentral gyrus and right postcentral gyrus decreased in the patient group.Correlation analysis showed that the THI score of the left posterior cingulate gyrus was positively correlated with the ALFF value of the left posterior cingulate gyrus(r=0.641,P<0.001),and negatively correlated with the SAS score of the right precentral gyrus(r=0.601,P<0.001).The brain regions with significant changes in low frequency amplitudes were taken as regions of interest to analyze the functional connections of the whole brain.the results showed that the functional connections of the left middle temporal gyrus the left middle occipital gyrus and the left postcentral gyrus were weakened.Conclusion The functional connection intensity of multiple brain regions in tinnitus patients with chronic kidney essence deficiency syndrome is abnormal,involving default network,limbic system,auditory network,visual network and other brain regions.The left posterior cingulate gyrus and the right precentral gyrus may be neuroimaging indicators for evaluating the severity of tinnitus and negative emotion of tinnitus respectively.