原發(fā)性閉角型青光眼患者丘腦—皮質(zhì)通路功能連接及腦網(wǎng)絡(luò)拓?fù)鋵傩缘撵o息態(tài)fMRI研究
發(fā)布時(shí)間：2018-10-29 18:08
【摘要】：目的:采用基于種子點(diǎn)的功能連接(functional connectivity,FC)和以圖論(graph theory)方法,分析原發(fā)性閉角型青光眼(primary angle-closure glaucoma,PACG)患者靜息態(tài)下丘腦-皮層通路功能連接及腦網(wǎng)絡(luò)拓?fù)鋵傩缘母淖?以期提高對(duì)PACG患者可能的神經(jīng)機(jī)理的認(rèn)識(shí),為臨床早期診斷和治療提供幫助。方法:招募33例PACG患者(PACG組)與33例年齡、性別相匹配的健康對(duì)照者(healthy controls,HC組),所有PACG患者均行相應(yīng)的眼科檢查,包括視網(wǎng)膜神經(jīng)纖維層(retinal nerve fiber layer,RNFL)厚度、眼內(nèi)壓(intraocular pressure,IOP)、靜脈杯盤(pán)比(cup to disc ratio,CDR)及視力(visual activity,VA)。所有受試者均行SIEMENS Trio Tim 3.0T MR掃描儀掃描,得到靜息態(tài)功能磁共振圖像(resting-state functional MRI,RS-fMRI)。數(shù)據(jù)處理主要分為:(1)采集靜息態(tài)數(shù)據(jù);(2)使用DPARSFA軟件包進(jìn)行數(shù)據(jù)預(yù)處理;(3)選取雙側(cè)丘腦的各7個(gè)亞區(qū)作為感興趣區(qū)(region of interest,ROI),并以此為種子點(diǎn)與全腦各體素進(jìn)行功能連接分析,并進(jìn)行組間兩獨(dú)立樣本t檢驗(yàn)(AlphaSim矯正,P0.01);(4)應(yīng)用Gretna腦網(wǎng)絡(luò)分析軟件包,選擇116個(gè)自動(dòng)解剖標(biāo)定(automated anatomical labeling,AAL)模板腦區(qū)為節(jié)點(diǎn),計(jì)算功能連接后獲得矩陣,構(gòu)建二值化腦網(wǎng)絡(luò),獲取腦網(wǎng)絡(luò)整體及局部屬性,并在局部屬性上行組間雙樣本t檢驗(yàn)(錯(cuò)誤發(fā)現(xiàn)率矯正(false discovery rate,FDR),P0.05);(5)分析差異腦區(qū)的相關(guān)系數(shù)值及網(wǎng)絡(luò)屬性值,使用SPSS v.17.0軟件,對(duì)其與臨床參數(shù)RNFLT,靜脈CDR,IOP及VA進(jìn)行Pearson相關(guān)性分析。結(jié)果:(1)與HC組比較,PACG組丘腦與視覺(jué)傳導(dǎo)通路(頂葉/楔前葉、額葉/額下回)及非視覺(jué)傳導(dǎo)通路(中央旁小葉、中央后回、邊緣葉/海馬旁回)功能連接減低,丘腦與視覺(jué)傳導(dǎo)通路(枕葉、頂葉/頂下小葉、顳葉/顳下回)以及非視覺(jué)傳導(dǎo)通路(小腦前葉/山頂)功能連接增加(P0.01,AlphaSim校正,簇≥29體素)。(2)在網(wǎng)絡(luò)稀疏度(0.1~0.6)下,PACG及HC組腦網(wǎng)絡(luò)標(biāo)準(zhǔn)化聚類(lèi)系數(shù)(γ)㧐1,標(biāo)準(zhǔn)化最短路徑長(zhǎng)度(λ)≈1,且其小世界指數(shù)(σ)㧐1,兩組均具有“小世界”屬性。(3)在最小及最大網(wǎng)絡(luò)稀疏度(0.32~0.42)下,與HC組比較,PACG組標(biāo)準(zhǔn)化聚類(lèi)系數(shù)(γ)輕度減低(P:0.283~0.453),標(biāo)準(zhǔn)化最短路徑長(zhǎng)度(λ)無(wú)變化(P:0.463~0.993),導(dǎo)致小世界指數(shù)(σ)輕度減低(P:0.322~0.548),但上述差異均無(wú)統(tǒng)計(jì)學(xué)意義(FDR矯正,P0.05)。PACG組全腦(E_(global))及局部(E_(local))效應(yīng)亦無(wú)明顯變化(FDR矯正,P0.05)。(4)在最小網(wǎng)絡(luò)稀疏度(0.32)下,與HC組比較,PACG患者組初高級(jí)視覺(jué)皮層(雙側(cè)距狀裂周?chē)印⒆髠?cè)枕上回、右側(cè)枕下回、雙側(cè)楔葉)標(biāo)準(zhǔn)化節(jié)點(diǎn)度顯著降低,背側(cè)視覺(jué)通路(右側(cè)丘腦、雙側(cè)顳中回)及非視覺(jué)通路(雙側(cè)補(bǔ)充運(yùn)動(dòng)區(qū)、右側(cè)海馬旁回、右側(cè)中央旁小葉、右側(cè)島蓋部額下回)標(biāo)準(zhǔn)化節(jié)點(diǎn)度顯著增高(FDR矯正,P0.05);背側(cè)視覺(jué)通路(左側(cè)枕上/下回、雙側(cè)楔葉、左側(cè)舌回)及非視覺(jué)通路(左背外側(cè)額上回、左側(cè)眶部額上/中回、左側(cè)海馬、左側(cè)豆?fàn)顨ず�、左�?cè)小腦半球、小腦蚓部)標(biāo)準(zhǔn)化節(jié)點(diǎn)介數(shù)減少,背腹側(cè)視覺(jué)通路(右側(cè)顳中回、左側(cè)顳下回)及非視覺(jué)通路(右側(cè)海馬旁回、右側(cè)中央旁小葉、雙側(cè)島蓋部額下回、雙側(cè)緣上回)標(biāo)準(zhǔn)化節(jié)點(diǎn)介數(shù)顯著增加(FDR矯正,P0.05)。(5)在最小網(wǎng)絡(luò)稀疏度(0.32)下,PACG組左側(cè)眶部額中回標(biāo)準(zhǔn)化節(jié)點(diǎn)介數(shù)與靜脈CDR呈正相關(guān)(r=0.406,P=0.019)。PACG組左側(cè)緣上回標(biāo)準(zhǔn)化節(jié)點(diǎn)介數(shù)與VA呈正相關(guān)(r=0.357,P=0.041);右側(cè)緣上回標(biāo)準(zhǔn)化節(jié)點(diǎn)介數(shù)與VA呈明顯正相關(guān)(r=0.558,P=0.001);左側(cè)豆?fàn)詈藰?biāo)準(zhǔn)化節(jié)點(diǎn)介數(shù)與VA呈正相關(guān)(r=0.355,P=0.043)。PACG組右側(cè)楔葉標(biāo)準(zhǔn)化節(jié)點(diǎn)度與VA呈負(fù)相關(guān)(r=-0.371,P=0.034)。PACG組其余腦區(qū)的標(biāo)準(zhǔn)化節(jié)點(diǎn)介數(shù)及標(biāo)準(zhǔn)化節(jié)點(diǎn)度值與RNFLT,靜脈CDR、IOP及VA均未見(jiàn)明顯相關(guān)。PACG患者靜息態(tài)丘腦-皮層差異腦區(qū)均未發(fā)現(xiàn)與臨床參數(shù)存在顯著相關(guān)性。結(jié)論:(1)PACG組存在包括丘腦視覺(jué)傳導(dǎo)通路及非視覺(jué)傳導(dǎo)通路(感覺(jué)運(yùn)動(dòng)及情感記憶)的連接異常,且其可影響患者視覺(jué)相關(guān)的認(rèn)知功能;(2)PACG組腦網(wǎng)絡(luò)存在穩(wěn)定且高效的“小世界”屬性,且其整體構(gòu)建具有均質(zhì)化趨勢(shì);(3)PACG組視覺(jué)及非視覺(jué)(軀體運(yùn)動(dòng))腦區(qū)的局部屬性存在改變,且涉及到默認(rèn)網(wǎng)絡(luò)(default mode network,DMN),推測(cè)DMN可能是造成PACG患者內(nèi)在心理活動(dòng)異常的機(jī)制之一;(4)PACG組視覺(jué)腦區(qū)與VA相關(guān),非視覺(jué)腦區(qū)分別與靜脈CDR及VA相關(guān)。
[Abstract]:Objective: To study the functional connection of hypothalamic-cortical pathway in patients with primary closed-angle glaucoma (PACG) and the changes of brain network topology in patients with primary closed-angle glaucoma (PACG) by using functional connectivity (FC) and graph theory. With a view to raising awareness of possible neural mechanisms in PACG patients, help is provided for early diagnosis and treatment of PACG. Methods: 33 patients with PACG (PACG group) and 33 healthy controls (HC) matched with age and sex were recruited. All PACG patients underwent corresponding ophthalmic examinations, including retinal nerve fiber layer (RNFL) thickness, intraocular pressure (IOP), Venous cup ratio (CDR) and visual activity (VA). All subjects were scanned by SIEMENS Trio Tim 3.0T MR scanner to obtain a resting-state functional magnetic resonance image (RS-fMRI). Data processing is mainly divided into: (1) collecting rest state data; (2) carrying out data pretreatment using DPARIMA software package; (3) selecting 7 sub-regions of the double-side thalamus as a region of interest and ROI), and performing functional connection analysis on the seed points and the whole brain voxels; Two independent sample t test (AlphaSim correction, P0. 01) was carried out; (4) Gretna brain network analysis software package was applied, 116 automatic anatomical labeling (AAL) template brain regions were selected as nodes, the matrix was obtained after functional connection, and two-valued brain networks were constructed. The whole and local properties of the brain network were obtained, and the two-sample t-test (false display rate, FDR) and P0.05) were detected in the local attribute ascending group; (5) the correlation coefficient value and the network attribute value of the difference brain region were analyzed, and the correlation coefficient value and the network attribute value of the difference brain region were analyzed, and compared with the clinical parameter RNFLT and the vein CDR using SPSS v. 174.0 software. Pearson correlation analysis was performed between IOP and VA. Results: (1) Compared with HC group, the functional connection between thalamus and vision conduction pathway in PACG group (parietal lobe/ anterior lobe, frontal lobe/ frontal lobe) and non-visual conduction pathway (central paralobular, central posterior, marginal leaf/ hippocampus) was reduced, thalamus and visual conduction pathway (occipital lobe, (P <0.01, AlphaSim correction, cluster 72.29 voxel). (2) In the network sparsity (0. 1 ~ 0. 6), the standard convergence coefficient of the PACG and HC groups was standardized. 1. Standardization of the shortest path length (IRR) to be 1, and its small world index (INR)? 1. Both groups have "Little World" Properties. (3) Under the minimum and maximum network sparsity (0. 32 ~ 0. 42), the standard poly-coefficient (INR) of PACG group was slightly decreased compared with HC group (P: 0. 283 ~ 0. 453), and the standard shortest path length (LAI) was not changed (P: 0. 463 ~ 0. 93), which resulted in a slight decrease in the index of small world (P: 0. 322 ~ 0. 548). None of these differences were statistically significant (FDR correction, P0.05). In PACG group, the effects of total brain (E _ ()) and local (E _ (local)) did not change significantly (FDR correction, P0.05). (4) Under the minimum network sparsity (0. 32), compared with HC group, the normalized node degree of the early advanced visual cortex of PACG group (the peripheral cortex of the double-side margin, the back of the left occipital nerve, the back of the right occipital and the double-side wedge) was significantly decreased, and the posterior side vision pathway (right thalamus, The normalized node degrees were significantly increased (FDR correction, P0.05); back-side vision pathway (left occipital/ inferior), double-side wedge leaf, The number of normalized nodes in the left-hand tongue and the non-visual pathway (on the left-back lateral frontal, left-left orbital, left-hand, left-hand, left-hand, left-hand, cerebellar hemisphere, cerebellar vermis) was reduced, and the dorsal-ventral visual pathway (right-hand side), There was a significant increase in the number of normalized nodes (FDR correction, P0.05). (5) Under the minimum network sparsity (0. 32), the number of normalized nodes in the left orbital fraction of the PACG group was positively correlated with the venous CDR (r = 0.406, P = 0.019). The number of normalized nodes on the left margin of PACG group was positively correlated with VA (r = 0.357, P = 0.043); the number of normalized nodes on the right margin was positively correlated with VA (r = 0.0558, P = 0.0001); the number of normalized nodes on the left side was positively correlated with VA (r = 0.355, P = 0.043). There was a negative correlation between the normalized node degree and VA (r =-0.371, P = 0.037). The number of normalized nodes and normalized node degree values of the rest of the brain regions in the PACG group were not significantly correlated with RNFLT, venous CDR, IOP and VA. There was no significant correlation with clinical parameters in the resting thalamus-cortex difference brain regions of PACG patients. Conclusion: (1) The PACG group has an abnormal connection including the visual conduction pathway of thalamus and the non-visual conduction pathway (sensory and emotional memory), and it can influence the cognitive function of the patient's vision; (2) The PACG group has stable and high efficiency. "Little World" (3) The local attributes of PACG group visual and non-visual (somatic movement) brain regions are changed, and involve the default network (DMN). It is estimated that DMN may be one of the mechanisms that cause abnormal mental activity in PACG patients. (4) The visual brain regions of PACG group were associated with VA, and the non-visual brain regions were associated with venous CDR and VA, respectively.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R445.2;R775
本文編號(hào)：2298408
[Abstract]:Objective: To study the functional connection of hypothalamic-cortical pathway in patients with primary closed-angle glaucoma (PACG) and the changes of brain network topology in patients with primary closed-angle glaucoma (PACG) by using functional connectivity (FC) and graph theory. With a view to raising awareness of possible neural mechanisms in PACG patients, help is provided for early diagnosis and treatment of PACG. Methods: 33 patients with PACG (PACG group) and 33 healthy controls (HC) matched with age and sex were recruited. All PACG patients underwent corresponding ophthalmic examinations, including retinal nerve fiber layer (RNFL) thickness, intraocular pressure (IOP), Venous cup ratio (CDR) and visual activity (VA). All subjects were scanned by SIEMENS Trio Tim 3.0T MR scanner to obtain a resting-state functional magnetic resonance image (RS-fMRI). Data processing is mainly divided into: (1) collecting rest state data; (2) carrying out data pretreatment using DPARIMA software package; (3) selecting 7 sub-regions of the double-side thalamus as a region of interest and ROI), and performing functional connection analysis on the seed points and the whole brain voxels; Two independent sample t test (AlphaSim correction, P0. 01) was carried out; (4) Gretna brain network analysis software package was applied, 116 automatic anatomical labeling (AAL) template brain regions were selected as nodes, the matrix was obtained after functional connection, and two-valued brain networks were constructed. The whole and local properties of the brain network were obtained, and the two-sample t-test (false display rate, FDR) and P0.05) were detected in the local attribute ascending group; (5) the correlation coefficient value and the network attribute value of the difference brain region were analyzed, and the correlation coefficient value and the network attribute value of the difference brain region were analyzed, and compared with the clinical parameter RNFLT and the vein CDR using SPSS v. 174.0 software. Pearson correlation analysis was performed between IOP and VA. Results: (1) Compared with HC group, the functional connection between thalamus and vision conduction pathway in PACG group (parietal lobe/ anterior lobe, frontal lobe/ frontal lobe) and non-visual conduction pathway (central paralobular, central posterior, marginal leaf/ hippocampus) was reduced, thalamus and visual conduction pathway (occipital lobe, (P <0.01, AlphaSim correction, cluster 72.29 voxel). (2) In the network sparsity (0. 1 ~ 0. 6), the standard convergence coefficient of the PACG and HC groups was standardized. 1. Standardization of the shortest path length (IRR) to be 1, and its small world index (INR)? 1. Both groups have "Little World" Properties. (3) Under the minimum and maximum network sparsity (0. 32 ~ 0. 42), the standard poly-coefficient (INR) of PACG group was slightly decreased compared with HC group (P: 0. 283 ~ 0. 453), and the standard shortest path length (LAI) was not changed (P: 0. 463 ~ 0. 93), which resulted in a slight decrease in the index of small world (P: 0. 322 ~ 0. 548). None of these differences were statistically significant (FDR correction, P0.05). In PACG group, the effects of total brain (E _ ()) and local (E _ (local)) did not change significantly (FDR correction, P0.05). (4) Under the minimum network sparsity (0. 32), compared with HC group, the normalized node degree of the early advanced visual cortex of PACG group (the peripheral cortex of the double-side margin, the back of the left occipital nerve, the back of the right occipital and the double-side wedge) was significantly decreased, and the posterior side vision pathway (right thalamus, The normalized node degrees were significantly increased (FDR correction, P0.05); back-side vision pathway (left occipital/ inferior), double-side wedge leaf, The number of normalized nodes in the left-hand tongue and the non-visual pathway (on the left-back lateral frontal, left-left orbital, left-hand, left-hand, left-hand, left-hand, cerebellar hemisphere, cerebellar vermis) was reduced, and the dorsal-ventral visual pathway (right-hand side), There was a significant increase in the number of normalized nodes (FDR correction, P0.05). (5) Under the minimum network sparsity (0. 32), the number of normalized nodes in the left orbital fraction of the PACG group was positively correlated with the venous CDR (r = 0.406, P = 0.019). The number of normalized nodes on the left margin of PACG group was positively correlated with VA (r = 0.357, P = 0.043); the number of normalized nodes on the right margin was positively correlated with VA (r = 0.0558, P = 0.0001); the number of normalized nodes on the left side was positively correlated with VA (r = 0.355, P = 0.043). There was a negative correlation between the normalized node degree and VA (r =-0.371, P = 0.037). The number of normalized nodes and normalized node degree values of the rest of the brain regions in the PACG group were not significantly correlated with RNFLT, venous CDR, IOP and VA. There was no significant correlation with clinical parameters in the resting thalamus-cortex difference brain regions of PACG patients. Conclusion: (1) The PACG group has an abnormal connection including the visual conduction pathway of thalamus and the non-visual conduction pathway (sensory and emotional memory), and it can influence the cognitive function of the patient's vision; (2) The PACG group has stable and high efficiency. "Little World" (3) The local attributes of PACG group visual and non-visual (somatic movement) brain regions are changed, and involve the default network (DMN). It is estimated that DMN may be one of the mechanisms that cause abnormal mental activity in PACG patients. (4) The visual brain regions of PACG group were associated with VA, and the non-visual brain regions were associated with venous CDR and VA, respectively.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R445.2;R775
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