摘要
目的观测类风湿关节炎(rheumatoid arthritis,RA)患者大脑皮层厚度及表面积的改变,探讨其与认知功能损害的关系。方法收集2016年12月至2017年5月在本院中西医结合科确诊的50例RA患者(RA组)及同期40例性别、年龄、受教育程度相匹配的健康志愿者(对照组)行高分辨率3D-T_1WI结构相扫描,利用Freesurfer软件分析两组间皮层厚度及表面积的差异,与患者的认知功能评分进行相关及回归分析。结果磁共振图像处理结果显示,与对照组比较,RA组的左侧额下回岛盖、额上回、额中回下部,右侧中央前回、海马旁回、皮层厚度明显的减低(P<0.05);右侧中央后回皮层表面积明显减低(P<0.05)。RA组MoCA及MMSE总分,视空间执行功能、注意、语言、延迟回忆、定向功能得分较对照组明显降低(P<0.05);控制年龄、受教育程度、病程后,经多元逐步回归,RA患者海马旁回皮层厚度与延迟回忆、定向功能评分,右侧中央前回皮层厚度与MoCA总分及语言、视空间执行功能等评分均呈正相关(P<0.05)。结论 RA患者多个脑区的皮层厚度变薄,表面积减少,认知功能存在受损,部分皮层厚度的改变与RA患者认知功能损害有关。
Objective To investigate the changes of cortical thickness and cortical surface area in rheumatoid arthritis （RA） patients, and explore the relationship of these changes with cognitive impairment. Methods A total of 50 RA patients admitted in the Department of Integrated Chinese and Western Medicine of our hospital from October 2016 to May 2017 were enrolled in this study. Another 40 heahhy w4unteers matched with sex, age and educational level served as control. All subjects underwent 3D-T1WI scanning. The original 3D-T1 WI brain images were analyzed with Freesuffer software, and the values of cortical thickness and surface area were extracted for the difference between the 2 groups. Correlation and regression analyses were used to determine the factors that affect the changes of cortical abnormalities with cognitive scores. Results The analysis on 3D-T1WI images showed that compared to the control group, the RA group had significantly decreased cortical thickness in left pars opercularis of inferior frontal gyms, left superior frontal gyms, left rostral middle frontal gyms, right precentral gyrus, and right para-hippocampal gyms （ P 〈 0.05 ） , and obviously declined cortical surface area in postcentral gyms （P 〈 0.05）. The total scores of MoCA and MMSE, visuospatial/executive, attention, language, delayed I^eall and orientation were significant reduced in the RA group than the control （P 〈 0.05）. After adjustment for age, educational level, course of disease, stepwise regression analysis indicated that right para-hippocampal cortical thickness were positively correlated with delayed recall score, right precentral cortex thickness and total scores of MoCA, language visuospatiaL/executive function （P 〈 0.05 ）. Conclusion The RA patients have significantly decreases in cortical thickness and surface areas, and are accompanied by cognitive impairment. The changes of some cortex thickness are obviously associated with cognitive impairment.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2018年第5期426-430,共5页
Journal of Third Military Medical University
基金
国家自然科学基金面上项目(81373180)~~
关键词
关节炎
类风湿
磁共振成像
认知
大脑皮层
arthritis, rheumatoid
magnetic resonance imaging
cognition
cortex
