本文選題：阻塞性睡眠呼吸暫停低通氣綜合征　切入點(diǎn)：基于體素水平度中心度　出處：《南昌大學(xué)》2017年碩士論文

【摘要】：目的:阻塞性睡眠呼吸暫停低通氣綜合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者已經(jīng)發(fā)現(xiàn)某些特定大腦結(jié)構(gòu)及腦局部功能的變化。然而,全腦功能網(wǎng)絡(luò)的拓?fù)浣M織屬性仍然不清楚。本研究采用基于體素水平的度中心度(voxel-wise degree centrality,DC)方法去探索OSAHS患者全腦功能網(wǎng)絡(luò)拓?fù)鋵傩约皟?nèi)在功能樞紐(hubs)區(qū)域的改變。方法:首先納入40例經(jīng)多導(dǎo)睡眠監(jiān)測(cè)(PSG)新確診的OSAHS患者及睡眠好的正常對(duì)照組(good sleepers,GS)40例參與本項(xiàng)研究。所有的被試者進(jìn)行了靜息狀態(tài)功能磁共振成像(functional magnetic resonance imaging,fMRI)掃描和臨床及認(rèn)知功能評(píng)估。其次,基于Matlab 2012a平臺(tái),采用DPABI及REST軟件包對(duì)靜息態(tài)功能磁共振數(shù)據(jù)進(jìn)行預(yù)處理,然后計(jì)算每一個(gè)被試全腦基于體素水平的DC值,采用單樣本及兩樣本t檢驗(yàn)分別比較組內(nèi)及組間參數(shù),提取OSAHS患者組間異常腦區(qū)的DC值,并與臨床評(píng)估量表進(jìn)行相關(guān)分析。最后,以O(shè)SAHS患者DC值減低的腦區(qū)作為感興趣區(qū)進(jìn)行全腦種子點(diǎn)功能連接(functional connectivity,FC)分析,進(jìn)一步去探索功能連接異常的腦區(qū)。結(jié)果:(1)OSAHS患者組及GS組存在高度相似的較高DC值分布(功能hubs)區(qū)域。然而,與GS組比較,OSAHS患者組左側(cè)枕中回、后扣帶皮層、左側(cè)額上回和雙側(cè)頂葉小葉的DC值顯著減低;而右側(cè)眶額葉皮質(zhì)、雙側(cè)小腦后葉和雙側(cè)豆?fàn)詈?延伸到殼核、海馬體及顳下回的DC值顯著增高,這些異常區(qū)域均位于功能hubs腦區(qū)內(nèi)。(2)種子點(diǎn)FC分析發(fā)現(xiàn),與GS組比較,OSAHS患者組減低的DC腦區(qū)與枕葉、額葉、顳葉、小腦等廣泛腦區(qū)功能連接減低。(3)線性相關(guān)分析發(fā)現(xiàn)OSAHS患者組呼吸紊亂指數(shù)與左側(cè)枕中回(r=-0.535,P=0.001)、左側(cè)頂下小葉(r=-0.415,P=0.012)、右側(cè)頂下小葉(r=-0.351,P=0.036)減低的DC值呈負(fù)相關(guān);覺(jué)醒指數(shù)與左側(cè)枕中回(r=-0.449,P=0.006)、左側(cè)頂下小葉(r=-0.360,P=0.031)、右側(cè)頂下小葉(r=-0.396,P=0.017)減低的DC值呈負(fù)相關(guān);蒙特利爾認(rèn)識(shí)功能評(píng)分與后扣帶回(r=0.406,P=0.014)、左側(cè)額上回(r=0.570,P0.001)減低的DC呈正相關(guān)。結(jié)論:(1)OSAHS患者存在特定內(nèi)在的異常的功能網(wǎng)絡(luò)拓?fù)鋵傩缘母淖?包括左側(cè)枕中回、后扣帶皮層、左側(cè)額上回和雙側(cè)頂葉小葉的DC值減低,右側(cè)眶額葉皮質(zhì)、雙側(cè)小腦后葉和雙側(cè)豆?fàn)詈说鹊腄C值增加;提示OSAHS患者功能網(wǎng)絡(luò)集成和分離異常及功能hubs節(jié)點(diǎn)存在損害及代償性改變。(2)部分異常腦區(qū)的DC值與認(rèn)知功能評(píng)分、疾病嚴(yán)重程度存在顯著的相關(guān),這可能是OSAHS患者認(rèn)知功能損害的可能神經(jīng)機(jī)制,將為我們理解OSAHS患者認(rèn)知功能損害的神經(jīng)病理機(jī)制提供了新的見(jiàn)解。
[Abstract]:Objective: obstructive sleep apnea hypopnea syndrome (OSAHS) patients with obstructive sleep apnea hypopnea syndrome (OSAHS) have found some changes in specific brain structure and brain function.However, the topological properties of the whole brain functional network are still unclear.In this study, we used a voxel-wise degree centrality DCA method based on voxel level to explore the topological properties of global functional network and the changes of internal functional hubs in patients with OSAHS.Methods: forty patients with OSAHS diagnosed by polysomnography and 40 healthy controls were included in this study.All subjects underwent resting state functional magnetic resonance imaging of MRI scans and evaluated their clinical and cognitive functions.Secondly, based on Matlab 2012a platform, DPABI and REST software package were used to preprocess the resting functional magnetic resonance data, and then the DC values of the whole brain based on voxel level were calculated.Single sample and two samples t test were used to compare the parameters in group and group respectively. DC values of abnormal brain regions in patients with OSAHS were extracted and correlated with clinical assessment scale.Finally, the functional connectivity of the whole brain was analyzed by using the brain region with decreased DC value in OSAHS patients as the region of interest, so as to further explore the abnormal functional connectivity areas.Results there was a highly similar distribution of high DC values (functional hubs) between the OSAHS and GS groups.However, the DC values of left occipital middle gyrus, posterior cingulate cortex, left superior frontal gyrus and bilateral parietal lobule in OSAHS group were significantly lower than those in GS group, while the right orbital frontal cortex, bilateral posterior cerebellar lobe and bilateral lenticular nucleus extended to putamen nucleus.The DC values of hippocampus and infratemporal gyrus were significantly increased. These abnormal areas were located in the functional hubs brain area. FC analysis showed that compared with the GS group, the DC decreased in the occipital, frontal and temporal lobes.灝忚剳絳夊箍娉涜剳鍖哄姛鑳借繛鎺ュ噺浣，

本文編號(hào)：1710128