摘要
目的基于静息态功能性磁共振成像,探讨颈动脉狭窄患者认知功能与海马体积及功能连接的相关性。方法对2019年1至12月于南京大学医学院附属鼓楼医院收治的40例颈动脉狭窄患者与社区招募的31名正常对照者行认知量表评估认知功能,结构磁共振检查测量海马体积,静息态磁共振检查全脑功能连接,分析两组的认知功能、海马体积及功能连接差异,探讨认知功能和海马体积及功能连接的相关性。结果颈动脉狭窄组简易精神状态量表(MMSE)(F=13.346,P=0.001)、蒙特利尔认知评估量表(MoCA)(F=52.005,P<0.001)评分显著低于正常对照组,差异有统计学意义。与正常对照组相比,颈动脉狭窄组全海马体积明显萎缩(右侧t=2.176,P=0.033;左侧t=2.881,P=0.005),以左侧为甚;海马尾(右侧t=2.394,P=0.019;左侧t=3.158,P=0.002)和海马体(右侧t=2.336,P=0.022;左侧t=3.165,P=0.002)体积较正常对照组缩小;颈动脉狭窄组不同海马亚区中下托(右侧t=2.211,P=0.030;左侧t=2.430,P=0.018)和分子层(右侧t=2.103,P=0.039;左侧t=2.702,P=0.009)体积显著缩小,其余各亚区体积差异无统计学意义(P均>0.05)。全海马体积与MoCA及MMSE评分呈正相关(左侧全海马MoCA:r=0.289,P=0.015;右侧全海马MMSE:r=0.249,P=0.038;左侧全海马MMSE:r=0.316,P=0.008);海马各亚区中双侧下托及前下托、左侧分子层体积变化与MoCA(右侧下托:r=0.290,P=0.015;左侧下托:r=0.382,P=0.001;右侧前下托:r=0.293,P=0.014;左侧前下托:r=0.440,P<0.001;左侧分子层:r=0.259,P=0.031)及MMSE评分(右侧下托:r=0.278,P=0.020;左侧下托:r=0.419,P<0.001;右侧前下托:r=0.296,P=0.013;左侧前下托:r=0.506,P<0.001;左侧分子层:r=0.298,P=0.012)呈正相关,其余影像学变化与认知评分无相关性(P均>0.05)。与正常人群相比,颈动脉狭窄患者左侧海马与枕叶及额叶,右侧海马与枕叶、颞叶、前额叶及额中回的功能连接减低(高斯随机场校正,体素水平P<0.01,团块水平P<0.05);
Objective To investigate the correlations among brain functional connectivity,hippocampal subregion volume and cognitive score in the patients with carotid artery stenosis(CAS)based on resting state functional magnetic resonance imaging.Methods Forty CAS patients treated in the Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University from January to December in 2019 and 31 healthy volunteers were enrolled in this study.All the participants underwent cognitive assessment,structural MRI for the measurement of hippocampal volume,and resting state functional magnetic resonance imaging for the examination of brain functional connectivity(FC).We compared the cognitive function,hippocampal subregion volumes,and brain functional connectivity between the two groups and investigated the correlations between the three indicators.Results The CAS patients had lower mini-mental state examination(MMSE)(F=13.346,P=0.001)and Montreal cognitive assessment(MoCA)(F=52.005,P<0.001)scores than the healthy volunteers.Compared with healthy volunteers,CAS patients showed small whole hippocampus(right side:t=2.176,P=0.033;left side:t=2.881,P=0.005;especially on the left side),small hippocampal tail(right side:t=2.394,P=0.019;left side:t=3.158,P=0.002),small hippocampal body(right side:t=2.336,P=0.022;left side:t=3.165,P=0.002),small subiculum(right side:t=2.211,P=0.030;left side:t=2.430;P=0.018),and small molecular layer(right side:t=2.103,P=0.039;left side:t=2.702,P=0.009).The whole hippocampal volume was positively correlated with MoCA and MMSE scores(left MoCA:r=0.289,P=0.015;right MMSE:r=0.249,P=0.038;left MMSE:r=0.316,P=0.008).The volume changes in the subiculum,presubiculum,and left molecular layer were positively correlated with MoCA(right subiculum:r=0.290,P=0.015;left subiculum:r=0.382,P=0.001;right presubiculum:r=0.293,P=0.014;left presubiculum:r=0.440,P<0.001;left molecular layer:r=0.259,P=0.031)and MMSE scores(right subiculum:r=0.278,P=0.020;left subiculum:r=0.419,P<0.001;right presubiculum:r=0.296,P=0.01
作者
苏比努尔·买买提艾力
张雯
李晓强
乔彤
Subinuer MAIMAITIAILI;ZHANG Wen;LI Xiaoqiang;QIAO Tong(Department of Vascular Surgery,Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University,Nanjing 210008,China;Department of Radiology,Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University,Nanjing 210008,China)
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2022年第6期980-989,共10页
Acta Academiae Medicinae Sinicae
基金
国家自然科学基金(81870348)
南京市医学重点科技发展项目(ZKX19019)。
关键词
颈动脉狭窄
认知功能
海马及亚区体积
功能连接
静息态功能性磁共振成像
carotid artery stenosis
cognitive function
hippocampal subregion volume
functional connectivity
resting state functional magnetic resonance imaging
