本文選題：靜息態(tài)功能磁共振　切入點(diǎn)：額葉腫瘤　出處：《南京航空航天大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：額葉腫瘤是顱內(nèi)常見腫瘤,大多會導(dǎo)致認(rèn)知損傷,并且神經(jīng)性功能缺失很早就出現(xiàn)。但在早期,多無明顯的臨床癥狀和顯著的功能障礙,給早期診斷帶來較大的困難。近年來,隨著認(rèn)知神經(jīng)心理學(xué)的發(fā)展,對額葉的神經(jīng)生理功能及額葉病變引起的癥狀有了進(jìn)一步的認(rèn)識,但仍缺乏更深入的全面了解,特別是對于早期額葉患者的認(rèn)知損傷和局部功能區(qū)改變的研究�；谘跛揭蕾嚨墓δ艽殴舱癯上�(Blood oxygenation level-dependent functional MRI,BOLD-fMRI)技術(shù)具有無創(chuàng)、高時空分辨率、可重復(fù)性好等特點(diǎn),已成為腦科學(xué)和生命科學(xué)研究的重要工具。而靜息狀態(tài)下不需要實(shí)驗(yàn)設(shè)計和刺激,也不需要被試做出反應(yīng),更容易被神經(jīng)疾病患者接受,已被廣泛用于大腦神經(jīng)性病變的研究中。本文基于靜息態(tài)功能磁共振技術(shù),分別從大腦功能分化和功能整合兩個方面分析額葉腫瘤患者大腦功能的異常改變,并分析額葉占位腫瘤并結(jié)合臨床認(rèn)知測試結(jié)果,尋找患者認(rèn)知損傷的可能存在因素,分析患者認(rèn)知損傷的病理生理機(jī)制,揭示對額葉腫瘤患者產(chǎn)生認(rèn)知功能代償?shù)哪X區(qū)。論文主要研究內(nèi)容如下:1.將低頻振蕩振幅和功能連接應(yīng)用到額葉腫瘤患者的認(rèn)知障礙研究,從神經(jīng)元的自發(fā)活性方面和腦功能連接的角度分析患者腦認(rèn)知的變化情況,得到患者較正常人認(rèn)知差異腦區(qū)并利用GCA分析差異腦區(qū)的信息交互的變化。結(jié)果顯示:與正常被試相比,額葉腫瘤患者在神經(jīng)元的自發(fā)活性和功能連接均存在顯著異常,主要表現(xiàn)在空間注意功能區(qū)和聽覺言語功能區(qū)。分析結(jié)果表明,顳葉和島葉所在的聽覺言語功能區(qū)受到額葉腫瘤的影響,但在顳葉內(nèi)部非受損區(qū)域有功能重組的現(xiàn)象。2.利用臨床上的認(rèn)知測試評估,將患者分為認(rèn)知正常組和認(rèn)知異常組,分別利用ALFF和FCD方法進(jìn)行分析,從神經(jīng)元自身活性和大腦功能連接兩方面對患者臨床認(rèn)知表現(xiàn)進(jìn)行分析,討論臨床認(rèn)知障礙原因。結(jié)果顯示:兩組的差異腦區(qū)主要表現(xiàn)在視覺空間功能區(qū)和空間注意功能區(qū)。分析結(jié)果認(rèn)為,可能是視覺處理或者說是視覺記憶功能區(qū)的變化,進(jìn)而導(dǎo)致認(rèn)知障礙。本文創(chuàng)新性地結(jié)合GCA分析方法,分析額葉腫瘤患者功能分化和功能整合的差異腦區(qū)的信息交互的變化,從有向網(wǎng)絡(luò)方面分析患者的認(rèn)知損傷機(jī)制;并結(jié)合臨床的認(rèn)知測試評估,探尋額葉腫瘤患者可能存在的大腦代償機(jī)制。
[Abstract]:Frontal lobe tumors are common intracranial tumors, most of which lead to cognitive impairment, and neurologic dysfunction occurs early. However, in the early stage, there are no obvious clinical symptoms and significant functional disorders, which brings great difficulties in early diagnosis. With the development of cognitive neuropsychology, the neurophysiological function of the frontal lobe and the symptoms caused by the lesion of the frontal lobe have been further understood, but there is still a lack of a more thorough and comprehensive understanding. In particular, the study of cognitive impairment and local functional area changes in early frontal lobe patients. Based on blood oxygen level dependent functional magnetic resonance imaging (fMRI), blood oxygenation level-dependent functional MRII-BOLD-fMRI has the characteristics of noninvasive, high spatial and temporal resolution, and good reproducibility. It has become an important tool in brain science and life sciences. At rest, there is no need for experimental design and stimulation, or for subjects to react, and they are more easily accepted by patients with neurological diseases. It has been widely used in the study of cerebral neuropathy. Based on resting functional magnetic resonance imaging (fMRI), the abnormal changes of brain function in patients with frontal lobe tumors were analyzed from the two aspects of functional differentiation and functional integration. The possible factors of cognitive impairment and the pathophysiological mechanism of cognitive impairment were analyzed. The main contents of this paper are as follows: 1. The low frequency oscillation amplitude and functional connection were applied to the study of cognitive impairment in patients with frontal lobe tumor. From the aspect of neuron spontaneous activity and the angle of brain functional connection, we analyze the changes of patients' brain cognition. The results showed that there were significant abnormalities in the spontaneous activity and functional connection of neurons in patients with frontal lobe tumor compared with normal subjects. The results showed that the auditory and verbal regions of temporal lobe and island lobe were affected by frontal lobe tumor. However, there is a phenomenon of functional recombination in the non-damaged areas within the temporal lobe. (2) the patients were divided into normal cognitive group and abnormal cognitive group by using clinical cognitive test. The results were analyzed by ALFF and FCD methods, respectively. The clinical cognitive performance of the patients was analyzed from the aspects of neuron self activity and brain function connection. This paper discusses the causes of clinical cognitive impairment. The results show that the difference between the two groups is mainly manifested in the visual spatial functional area and the spatial attention functional area. The results of the analysis suggest that it may be the change of visual processing or visual memory functional area. This paper innovatively combined with GCA analysis method to analyze the changes of information interaction between functional differentiation and functional integration of patients with frontal lobe tumor, and analyze the cognitive damage mechanism of patients from the point of view of directed network. Combined with the evaluation of clinical cognitive test, the possible brain compensatory mechanism in frontal lobe tumor patients was explored.
【學(xué)位授予單位】：南京航空航天大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R445.2;R739.41

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