本文選題：盲人　切入點(diǎn)：結(jié)構(gòu)重塑　出處：《天津醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：【目的】前期研究報(bào)道長期視覺剝奪后視覺皮層發(fā)生了結(jié)構(gòu)重塑,但是對(duì)枕葉視覺皮層以外的視覺信息處理通路的結(jié)構(gòu)重塑關(guān)注較少。本研究的目的是探索不同失明年齡段盲人全腦皮層厚度、表面積以及體積的潛在重塑,重點(diǎn)關(guān)注視覺經(jīng)驗(yàn)對(duì)枕葉視覺皮層以外腦區(qū)皮層結(jié)構(gòu)重塑的影響;通過引入線性和指數(shù)模型,探討這些盲人重塑腦區(qū)結(jié)構(gòu)改變與失明年齡的內(nèi)在關(guān)系,以探討這些腦區(qū)的結(jié)構(gòu)重塑的形成機(jī)制。【對(duì)象與方法】本研究對(duì)象包括不同失明年齡段的盲人與正常對(duì)照,共145人。包括先盲18例(無視覺經(jīng)驗(yàn)),早盲30例(失明年齡為1-12歲),晚盲47例(失明年齡大于12歲),以及性別與年齡相匹配的正常對(duì)照者50例。采集所有受試者的三維T1結(jié)構(gòu)像,使用Freesurfer重建每個(gè)被試的腦皮層(灰白質(zhì)面和軟腦膜面),計(jì)算皮層形態(tài)定量表征(厚度、表面積與體積)。首先引入一般線性模型(以腦定量表征作為因變量,分組作為自變量,年齡和性別作為無關(guān)變量回歸掉),基于皮層最小單元(vertex)分析全腦各組之間腦形態(tài)定量表征的差異。將皮層結(jié)構(gòu)出現(xiàn)明顯差異的腦區(qū)作為感興趣區(qū),提取出這些腦區(qū)的平均腦定量表征,分別利用線性和指數(shù)模型,探討感興趣區(qū)內(nèi)平均皮層厚度與失明年齡的線性和非線性關(guān)系。【結(jié)果】(1)與正常對(duì)照相比,先盲枕葉皮層厚度明顯增加,主要位于雙側(cè)初級(jí)視覺皮層、舌回和楔葉等,而雙側(cè)顳極與內(nèi)嗅皮層厚度顯著減低;早盲枕葉皮層厚度未見顯著改變;晚盲主要表現(xiàn)為枕葉皮層厚度減低,包括雙側(cè)枕下回、舌回、梭狀回與左側(cè)楔葉等。早盲與晚盲均未見顯著的顳極與內(nèi)嗅皮層厚度改變。(2)各亞組盲人與正常對(duì)照相比均主要表現(xiàn)為內(nèi)側(cè)枕葉皮層表面積減低,包括初級(jí)視覺皮層、楔葉、舌回、梭狀回等腦區(qū)。其中以初級(jí)視覺皮層表面積減低最顯著,而且晚盲面積減低范圍最廣泛。(3)各亞組盲人與正常對(duì)照相比主要表現(xiàn)為枕葉皮層體積減低,晚盲變化范圍最廣泛,早盲次之。分布范圍相較皮層表面積變化而言更局限。(4)在枕葉皮層,基于感興趣區(qū)的研究發(fā)現(xiàn):先盲枕葉皮層感興趣區(qū)的皮層厚度顯著高于正常人和其它幾組盲人;而皮層表面積顯著低于其它組;先盲枕葉皮層體積顯著高于其它盲人組,而與正常人無顯著差異。早盲和晚盲枕葉皮層體積顯著低于正常人。(5)在顳極和內(nèi)嗅皮層,基于感興趣區(qū)的研究發(fā)現(xiàn):先盲的皮層厚度顯著低于其它盲人組和正常人,而早盲和晚盲的皮層厚度與正常人無顯著差異;四組之間該腦區(qū)的皮層表面積無顯著差異;先盲左側(cè)顳極的體積相比晚盲和正常人減低。(6)基于曲線擬合的結(jié)果顯示:各感興趣區(qū)的皮層厚度與失明年齡的關(guān)系使用指數(shù)模型擬合優(yōu)度最佳,提示視覺經(jīng)驗(yàn)對(duì)視覺相關(guān)皮層的結(jié)構(gòu)重塑存在敏感期,具體表現(xiàn)為:在枕葉皮層,隨著失明年齡的增加,盲人皮層厚度呈指數(shù)減低,1-2歲后失明者,盲人枕葉皮層厚度趨于穩(wěn)定,與正常人相差不大;而在枕葉外的顳極和內(nèi)嗅皮層,隨著失明年齡的增加,盲人皮層厚度呈指數(shù)增加,2-5歲失明者,盲人皮層厚度趨于穩(wěn)定�！窘Y(jié)論】視覺剝奪后盲人不僅枕葉內(nèi)視覺亞區(qū),而且腹側(cè)視覺通路上顳極與內(nèi)嗅皮層等結(jié)構(gòu)也發(fā)生了結(jié)構(gòu)重塑:(1)所有盲人枕葉視覺皮層表面積普遍萎縮,提示繼發(fā)于前視覺通路損害的軸突變性機(jī)制在所有盲人均發(fā)揮作用;(2)僅先盲枕葉視覺皮層增厚提示其存在關(guān)鍵期,是軸突變性、皮層發(fā)育及經(jīng)驗(yàn)依賴性可塑性共同作用的結(jié)果。(3)先盲顳極和內(nèi)嗅皮層變薄主要與經(jīng)驗(yàn)依賴性可塑性機(jī)制有關(guān)。
[Abstract]:[Objective] the study reported long after visual deprivation visual cortex occurred in structural remodeling, but the occipital visual cortex outside the visual information processing pathway remodeling less attention. The purpose of this study is to explore the different ages of the blind blind the cortical thickness, surface area and potential remodeling volume, focused on the visual experience the occipital visual cortex cerebral cortex than structural remodeling; through the introduction of linear and exponential model, to explore the internal relations of these brain structure changes and remodeling of the blind blind age, the formation mechanism of structural remodeling of these brain regions. [method] the study object and the object of different ages including blind blind and normal control, a total of 145 people. 18 cases including the first blind (no visual experience), 30 cases (blind blind as early as age 1-12), 47 cases (late blind blind age more than 12 years), and gender and 50 normal subjects matched for age. The three-dimensional structure of T1 collected in all subjects like, the use of Freesurfer reconstruction of each participant and the cerebral cortex (gray matter surface and surface morphology of cortex, PIA) calculation of quantitative characterization (thickness, surface area and volume). Firstly, the general linear model (in the brain as a quantitative characterization the dependent variable grouping as independent variables, age and gender as independent variable regression, the smallest unit off) cortex (vertex) based on analysis of differences between groups of whole brain brain morphology. The quantitative characterization of cortical structures appear significantly different brain regions as region of interest, the average brain extract quantitative characterization of these brain regions, respectively, by linear and exponential model to investigate the linear and nonlinear relationships in mean cortical thickness and blind age. [results] (1) compared with normal control, the first blind occipital cortex thickness increased significantly, mainly in the bilateral The primary visual cortex, cuneus and lingual gyrus, and bilateral temporal and entorhinal cortex thickness decreased significantly; the early blind occipital cortex thickness had no significant change; late blind is mainly occipital cortex thickness reduction, including the bilateral inferior occipital gyrus, lingual gyrus, fusiform gyrus and left cuneus. Early blind and night blind showed no significant temporal and entorhinal cortex thickness change. (2) the subgroup of the blind and normal controls were mainly manifested as medial occipital cortex decreased surface area, including the primary visual cortex, cuneus, lingual gyrus, fusiform gyrus and other brain regions. The surface area of the primary visual cortex the most significant decrease, and reduce the blind area late most widely range. (3) the subgroup of the blind and normal controls were mainly occipital cortex volume decreased, the most widely varied night blind, blind early times. The distribution range of cortical surface area changes compared to more limitations. (4) in the occipital cortex based on the interest. Study on the interest region found that cortical thickness first blind occipital cortex region of interest was significantly higher than that of normal people and several other groups of blind; and the cortical surface area was significantly lower than other groups; the first blind occipital cortex volume was significantly higher than that of other blind group, but no significant difference with normal people. Early and late blind blind occipital cortex the volume was significantly lower than that of normal people. (5) in the temporal pole and the entorhinal cortex, a region of interest based on the study found: cortical thickness was significantly lower than the other first blind blind group and normal people, and there was no significant difference between early and late cortical thickness of blind blind and normal people; no significant differences in the cerebral cortex of table the area between the four groups; the first blind left temporal pole compared to the volume of normal people and reduce the blind late. (6) based on the results of curve fitting showed that the relationship between cortical thickness and blind age of each region of interest using the index model of the best model, suggesting that visual experience on visual related skin There is a sensitive period for the remodeling of the specific performance: in the occipital cortex, with increasing age of the blind, blind cortical thickness index was decreased after 1-2 years old and blind, blind occipital cortex thickness tends to be stable, and the normal people have little difference; while in the occipital lobe temporal and entorhinal cortex, with the age of the blind blind increase, cortical thickness increases exponentially, 2-5 years old and blind, blind cortical thickness tends to be stable. [Conclusion] after visual deprivation not only blind occipital Jueya optic zone, and the ventral visual pathway temporal pole and entorhinal cortex structure occurred in structural remodeling: (1) all the blind pillow leaf surface area is shrinking in the visual cortex, suggesting that secondary to anterior visual pathway impairment of axonal degeneration mechanisms play a role in all of the blind; (2) only the first blind occipital visual cortex thickening suggesting there is a critical period, is axonal degeneration, cortical development and experience dependent The result of the common action of sexual plasticity. (3) the thinning of the blind temporal and the olfactory cortex is mainly related to the mechanism of empirical dependence plasticity.

【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.2;R338

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