摘要
目的 应用基于体素形态测量学（VBM）技术检测脑瘫患儿粗大运动功能相关的脑灰质结构,探讨脑瘫相关脑机制.方法 回顾性分析2012年10月至2013年12月于安徽医科大学第一附属医院就诊的40例脑瘫患儿资料.其中男26例、女14例,平均年龄（3.6±2.0）岁,对其进行粗大运动功能分级（GMFCS）和全脑3D结构像扫描.利用VBM 5对全脑容积进行分割,获得脑灰质、脑白质、脑脊液容积.在Matalab 7.1环境下运行SPM 5,采用相关分析法分析GMFCS与全脑灰质容积相关性.结果 GMFCS与灰质容积成显著正相关性的脑区主要有左颞中回（Z=3.57）及颞下回（Z=3.40）、右侧丘脑及豆状苍白球（Z=3.36）、左侧丘脑及豆状苍白球（Z=2.76）、左缘上回（Z=3.14）、左楔前叶（Z=3.00）、右背外侧额上回（Z=3.08）、右枕上回及枕中回（Z=2.84）（P均＜0.005）;成负相关性脑区主要有左眶部额中回及前扣带回（Z =3.28、3.02）、左内侧额上回（Z=3.19）、左尾状核（Z=3.04、2.94、2.92）、左侧小脑（Z=2.94）、右侧小脑（Z=2.97）、左侧海马旁回（Z=3.94）、右侧海马旁回（Z=3.43、3.00）、左侧岛叶（Z=3.50）、右侧岛叶（Z=3.41、3.80）、左侧舌回（Z=3.37）、右侧舌回（Z=3.30）、左后扣带回（Z=2.73）、左枕中回（Z=2.92）及右颞中回（Z=3.05）（P均＜0.005）.结论 基于VBM研究发现脑瘫患儿GMFCS与运动、情绪、记忆和默认网络脑灰质结构异常有关.
Objective To measure gray matter volume of whole brain with voxel-based morphometry （VBM） method and to study brain structures associated with gross motor function.Method Forty children with cerebral palsy were recruited in the authors＆#39; hospital from Oct.2012 to Dec.2013 （26 male,14 female cases,average age （3.6 ± 2.0） years）.Gross motor function classification system （GMFCS） for children was used to obtain their motor function.The whole-brain three dimensional magnetic resonance imaging （MRI） was performed on a 3.0 T MRI scanner.The data were segmented by VBM 5,and the whole brain volumes of gray matter,white matter and cerebospinal fluid were produced.Correlation analysis was used to analyze the correlation of GMFCS with whole brain volumes using SPM 5 in Matalab 7.1.Result The volume in left meditemporal gyrus （Z =3.57） and inferior temporal gyrus （Z =3.40）,right thalamus and pallidum （Z =3.36）,left thalamus and pallidum （Z =2.76）,left supramarginal gyrus （Z =3.14）,left precuneus gyrus （Z =3.00）,right dorsolateral superior frontal gyrus （Z =3.08）,right superior and medial occipital gyrus （Z =2.84） significantly increased as aggravation of gross motor dysfunction.The volume of the left medial orbitofrontal lobe and anterior cingulate （Z =3.28,3.02）,left medial superior frontal gyrus （Z =3.19）,left caudate （Z =3.04,2.94,2.92）,left cerebellum （Z =2.94）,right cerebellum （Z =2.97）,left parahippocampal （Z =3.94）,right parahippocampal （Z =3.43,3.00）,left insula （Z =3.50）,right insula （Z =3.41,3.80）,left lingual （Z =3.37）,right lingual （Z =3.30）,left post cingulum （Z =2.73）,left midioccipital gyrus （Z =2.92） and right miditemporal gyrus （Z =3.05） significantly reduced as the aggravation of gross motor dysfunction （P all 〈 0.005）.Conclusion GMFCS in children with cerebral palsy is related to abnormalities of brain gray matter structure for motor,emotion,memory and default model network when examined
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2015年第9期696-700,共5页
Chinese Journal of Pediatrics
基金
国家自然科学基金（81171326）
教育部博导专项联合基金（20123420110001）
关键词
脑性瘫痪
磁共振成像
大脑皮质
运动障碍
Cerebral palsy
Magnetic resonance imaging
Cerebral cortex
Movement disorders
