摘要
目的 应用比较局部一致性方法来观察阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者静息态脑功能磁共振的改变.方法 对2014年11月至2015年6月经东南大学附属中大医院耳鼻喉门诊接待或者广告招募的15例OSAHS患者以及15名健康对照的静息态磁共振血氧水平依赖（BOLD）数据进行后处理,获得局部一致性（ReHo）图像,并比较两组间ReHo的差异.结果 OSAHS组较健康对照组ReHo增加（P＜0.05,AlphaSim校正）的脑区包括右侧小脑后叶（t=4.292 1,P＜0.01）、左侧小脑后叶（t=4.350 6,P＜0.01）、右侧脑干（t=5.276 6,P＜0.01）、右侧枕叶（t=3.620 9,P=0.001）、左侧基底节区（t=3.385 6,P=0.002）及左侧颞叶（t=4.781 2,P＜0.01）.OSAHS组较健康对照组ReHo减低（P＜0.05,AlphaSim校正）的脑区包括右侧额中回（t=-3.5644,P=0.001）、右侧顶下小叶（t=-4.123 7,P＜0.01）及两侧额上回（t=-3.5009,P=0.002）.而且两侧小脑后叶的ReHo值与简易精神状态量表（MMSE）之间呈显著正相关（r=0.682,P=0.012）;与逻辑记忆测试（LMT）之间呈显著正相关（r=0.623,P=0.013）;与LMT-延迟回忆之间呈显著正相关（r =0.577,P=0.024）;与连线测试B（TMT-B）之间呈显著负相关（r=-0.723,P=0.002）.右侧额中回的ReHo值（r=0.661,P=0.007）与连线测试A（TMT-A）之间呈显著正相关.结论 OSAHS患者广泛的脑区出现了ReHo值的变化,提示该类患者大脑功能出现了代偿性的改变.两侧小脑后叶及右侧额中回异常的ReHo值可能是评估OSAHS患者神经损伤的生物学标记,为解释OSAHS患者出现的神经功能损伤提供了可能的机制.
Objective To investigate the change of regional homogeneity （ReHo）in patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） using resting-state functional magnetic resonance imaging（fMRI）.Methods Resting-state fMRI data were collected from 15 patients with OSAHS and 15 normal controls.Patients were enrolled from the Sleep Laboratory of the Otolaryngology-Head and Neck Surgery Department of Zhongda Hospital,Southeast University,Nanjing from November 2014 to June 2015.The data were analyzed with the ReHo method and compared between OSAHS and controls.Results The ReHo showed a significant increase in the posterior lobe of right cerebellum （t =4.292 1,P ＜ 0.01）,posterior lobe of left cerebellum （t =4.350 6,P ＜0.01）,right brainstem （t =5.276 6,P ＜0.01）,right occipital lobe （t =3.620 9,P =0.001）,left basal ganglia （t =3.385 6,P =0.002） and left temporal lobe （t =4.781 2,P ＜ 0.01） and a decrease in the right middle frontal gyrus （t =-3.564 4,P =0.001）,right inferior parietal lobe （t =-4.123 7,P ＜ 0.01） and bilateral superior frontal gyrus （t =-3.500 9,P =0.002） in patients with OSAHS.Furthermore,the average ReHo values of the posterior lobe of bilateral cerebellum was positively correlated with the MMSE scores （r =0.682,P =0.012）,the LMT scores （r =0.623,P =0.013） and the LMT-delayed recall scores （r =0.577,P =0.024）,while negatively correlated with the TMT-A scores （r =-0.723,P =0.002）;the average ReHo values of the right middle frontal gyrus （r =0.661,P =0.007） was positively correlated with the TMT-A scores.Conclusion The current findings indicate that significant changes of ReHo in the global brain regions have been detected in OSAHS patients and the compensatory change of brain function occur.Abnormal ReHo values in the posterior lobe of bilateral cerebellum and right middle frontal gyrus could serve as potential biomarkers for assessment of neuronal damage and further provides insights into the biological mechanism of the diseas
出处
《中华医学杂志》
CAS
CSCD
北大核心
2016年第11期868-873,共6页
National Medical Journal of China
关键词
磁共振成像
睡眠呼吸暂停综合征
局部一致性
Magnetic resonance imaging
Sleep apnea syndromes
Regional homogeneity
