摘要
目的探讨卒中后认知障碍(post-stroke cognitive impairment,PSCI)患者上额枕束、下额枕束、扣带束的改变,并分析其与临床认知障碍严重程度的相关性。方法选取本院神经内科2020年1月至2021年1月首次左侧基底节区急性期缺血性卒中患者,利用DTI技术(diffusion tensor imaging,DTI)联合DTT技术(diffusion tensor tracking,DTT)对脑白质纤维束的数量及各向异性分数(fractional anisotropy,FA)进行检测,并于6个月后对每一例研究对象进行简单精神状态检查表(MMSE)、蒙特利尔认知评估量表(MoCA)评定,根据测评结果将研究对象分为卒中后认知障碍组(PSCI组20例),无卒中后认知障碍组(N-PSCI组20例),并入组基础信息无统计学差异的20例健康志愿者作为正常对照组(NORM组20例)。最后对白质纤维束的数量及部分各向异性分数(FA值)与量表评分之间进行相关性分析。结果PSCI组患者病灶侧上额枕束、下额枕束、扣带束的FA值较N-PSCI组及NORM组均有显著降低(P<0.01),差异有统计学意义;且PSCI组患者病灶侧上额枕束、下额枕束、扣带束的FA值与MMSE、MoCA评分成正相关,以P<0.01为差异有统计学意义。Pearson相关性分析显示,PSCI组病灶侧上额枕束、下额枕束、扣带束FA值(r=0.560,P=0.010;r=0.736,P=0.000;r=0.829,P=0.000)及纤维束数量(r=0.856,P=0.000;r=0.586,P=0.007;r=0.663,P=0.001)与MMSE评分呈正相关,以及其FA值(r=0.568,P=0.009;r=0.823,P=0.000;r=0.969,P=0.000)及纤维束数量(r=0.817,P=0.000;r=0.600,P=0.005;r=0.794,P=0.000)与MoCA评分呈正相关。结论上额枕束、下额枕束、扣带束参与了卒中后认知障碍的发生。
Objective To investigate the changes of the superior fronto-occipital fascicles,inferior fronto-occipital fascicles and cingulum fibers in patients with post-stroke cognitive impairment(PSCI)as well as analyze its correlation with the severity of clinical cognitive impairment.Methods Patients with acute ischemic stroke in the left basal segmental region were selected from the Department of Neurology of the First Affiliated Hospital of Jinzhou Medical University from July 2019 to July 2020.The number and the fractional anisotropy(FA)of white matter fiber bundles were measured using DTI combined with DTT.After 6 months,each subject was assessed using MMESE and MoCA.According to the evaluation results,the subjects were divided into post-stroke cognitive impairment group(PSCI group,20 cases)and non-post-stroke cognitive impairment group(N-PSCI group,20 cases).20 healthy volunteers with no statistical difference in basic information were included as the normal control group(NROM group,20 cases).Finally,the correlation between the number and partial anisotropy(FA)of white matter fiber bundles and the scale score was analyzed.Results The FA values of the superior fronto-occipital fascicles,inferior fronto-occipital fascicles and cingulum fibers in PSCI group were significantly lower than those in N-PSCI group and NORM group,and the difference was statistically significant(P<0.01);in addition,FA values of the superior fronto-occipital fascicles,inferior fronto-occipital fascicles and cingulum fibers in PSCI group were positively correlated with MMSE and MoCA scores,and the different was statistically significant(P<0.01).Pearson correlation analysis showed that FA values of the superior fronto-occipital fascicles,inferior fronto-occipital fascicles,cingulum fibers on the side of the lesion in the PSCI group(r=0.560,P=0.010;r=0.736,P=0.000;r=0.829,P=0.000)and fiber bundle number(r=0.856,P=0.000;r=0.586,P=0.007;r=0.663,P=0.001)were positively correlated with MMSE score and its FA value(r=0.568,P=0.009;r=0.823,P=0.000;r=0.96
作者
董彬彬
段晓迪
隋汝波
邓丽君
祁杰
张磊
Dong Binbin;Duan Xiaodi;Sui Rubo;Deng Lijun;Qi Jie;Zhang Lei(Department of Neurology,the First Affiliated Hospital of Jinzhou Medical University;School of Nursing,Jinzhou Medical University,Jinzhou 121000 China)
出处
《锦州医科大学学报》
2022年第2期80-84,88,共6页
Journal of Jinzhou Medical University
基金
国家自然科学基金项目,项目编号:81371461,81241050
辽宁省教育厅科技项目,项目编号:JYTJCZR201903
辽宁省教育厅青年基金项目,项目编号:JYTQN201707。
关键词
卒中后认知障碍
上额枕束
下额枕束
扣带束
post-stroke cognitive impairment
superior fronto-occipital fascicles
inferior fronto-occipital fascicles
cingulum fibers
