摘要
目的应用功能性近红外光谱成像技术(fNIRS)对库欣病患者言语流畅任务(VFT)期间双侧前额叶和双侧颞叶大脑皮层激活特征进行初步探索。方法纳入2020年7月—2022年7月在瑞金医院神经外科接受手术治疗的30例库欣病(CD)患者作为CD组,并招募30名健康者作为正常对照组(NC组)。对研究对象进行认知、焦虑及抑郁情绪、生存质量量表评估,并用近红外光谱成像仪器检测VFT期间双侧前额叶和双侧颞叶大脑皮层激活特征。最后,对CD组双侧前额叶和双侧颞叶氧合血红蛋白积分值与临床资料间进行相关性分析。结果CD组MoCA认知评分低于NC组(27分vs.30分,P<0.01);CD组各项焦虑及抑郁情绪量表评分高于NC组,SF-36生存质量量表各项评分低于NC组,各项量表评分均具有组间统计学差异(P<0.01)。CD组VFT期间双侧前额叶氧合血红蛋白积分值低于NC组[(56.36±39.09)mmol·mm vs.(132.70±64.27)mmol·mm,P<0.01],双侧颞叶氧合血红蛋白积分值低于NC组[(116.31±65.73)mmol·mm vs.(179.07±90.48)mmol·mm,P<0.01],任务态期间组词数少于NC组[(11.13±2.30)个vs.(12.97±3.26)个,P=0.03]。相关性分析发现,CD组双侧前额叶氧合血红蛋白积分值与临床资料间无相关性;双侧颞叶氧合血红蛋白积分值与SF-36生理职能评分间存在相关性(r=0.36,P=0.04),与其他临床资料间未见相关性。结论库欣病患者执行言语流畅任务时双侧前额叶及双侧颞叶大脑皮层激活程度降低,患者表现出认知功能受损、焦虑及抑郁情绪、生存质量下降,双侧颞叶氧合血红蛋白积分值与SF-36生理职能评分间呈现正相关。该项临床研究提示fNIRS技术可良好应用于库欣病患者脑功能实时监测与评估。
Objective To use functional near-infrared spectroscopy(fNIRS)to investigate the spatial pattern of the bilateral prefrontal and temporal cortex activation during Verbal Fluency Task(VFT)in patients with Cushing's disease(CD).Methods 30 patients with CD who underwent surgical treatment in Department of Neurosurgery,Ruijin Hospital from July 2020 to July 2022 were included as CD group,and 30 healthy individuals were recruited as the normal control group(NC group).The scale evaluation was performed on all subjects including cognitive scale,anxious and depressive scale,quality of life scale.Then,the spatial pattern of activation in the bilateral prefrontal and temporal cortex measured by fNIRS during VFT was recorded.The spatial pattern of brain activation during VFT was compared between two groups,and the correlation between the oxyhemoglobin integral value of bilateral prefrontal or temporal cortex and clinical characteristics were explored in CD group.Results The MoCA score of CD group was lower than that of NC group(27 vs.30,P<0.01).The scores of anxious and depressive assessments of CD group were significantly higher than NC group,and the SF-36 quality of life scores of CD group were lower than that of NC group,with a statistical difference(P<0.01).Compared with NC group,the bilateral prefrontal integral value(FIV)and bilateral temporal integral value(TIV)in CD group were significantly lower during VFT[(56.36±39.09)mmol·mm vs.(132.70±64.27)mmol·mm,P<0.01,(116.31±65.73)mmol·mm vs.(179.07±90.48)mmol·mm,P<0.01].The number of words during VFT in CD group was lower than NC group(11.13±2.30 vs.12.97±3.26,P=0.03).Further correlation analysis revealed that there was no correlation between the FIV and clinical characteristics in CD group.There was a correlation between the TIV and SF-36 physiological function score,with a statistical difference(r=0.36,P=0.04),while no correlation between the TIV and other clinical parameters were observed.Conclusions This clinical research reveals that the activation of bilater
作者
杨浩
宋小慧
王宝锋
任杰
卞留贯
YANG Hao;SONG Xiaohui;WANG Baofeng(Department of Neurosurgery,Ruijin Hospital Affiliated to Shanghai Jiaotong University Medical School,Shanghai 200025,China)
出处
《临床神经外科杂志》
2023年第6期607-613,共7页
Journal of Clinical Neurosurgery
基金
国家自然科学基金资助项目(82000751)。
关键词
库欣病
功能性近红外光谱成像
认知功能
精神症状
生存质量
Cushing's disease
functional near-infrared spectroscopy
cognitive function
psychiatric symptoms
quality of life
