成人雙側(cè)重度感音神經(jīng)性聾靜息態(tài)功能性磁共振成像特點的研究
發(fā)布時間：2018-12-16 20:08
【摘要】：目的和意義聽覺皮層是聽覺的高級中樞,位于顳上回及顳橫回內(nèi),主要功能是用于處理聽覺傳入信息,當(dāng)聽覺產(chǎn)生時,部分其他腦區(qū)也參與聽覺相關(guān)活動。耳聾發(fā)生后,聽覺皮層將發(fā)生功能重組,并參與處理其他非聽覺信息,而語前聾和語后聾的重組模式不同。我們利用靜息態(tài)功能性磁共振(fMRI)功能連接方法觀察成人不同類型重度感音神經(jīng)性聾的聽覺相關(guān)皮層重塑模式,了解語前聾和語后聾的聽覺中樞重塑特點,為其進一步干預(yù)治療提供依據(jù)。研究方法選取2016年3月至2016年11月在我院就診的雙側(cè)重度以上感音神經(jīng)性聾成人患者共20例,其中語前聾10例,語后聾10例,另選取聽力正常者20例作對照組。使用3.0T超導(dǎo)磁共振機進行常規(guī)T1WI、T2WI、T2-FLAIR序列掃描后進行靜息態(tài)fMRI掃描及結(jié)構(gòu)像掃描。將數(shù)據(jù)進行預(yù)處理,選取雙側(cè)初級聽覺皮層為種子點,運用靜息態(tài)fMRI功能連接方法分析3組受試者的腦功能成像表現(xiàn)。對3組受試者的數(shù)據(jù)分別做單樣本t檢驗,兩組間對比采用獨立樣本t檢驗,Alphasim校正,閾值分別為P0.01和P0.05,最小有意義激活數(shù)分別為K18 和 K85。結(jié)果分別以左側(cè)和右側(cè)BA41區(qū)為種子點時,正常組的正激活腦區(qū)主要包括雙側(cè)的顳上回、腦島、前扣帶回、輔助運動區(qū)等。語前聾組的正激活腦區(qū)主要包括雙側(cè)的顳上回、腦島、前扣帶回、中央后回、中央前回、枕下回等。語后聾組的正激活腦區(qū)主要包括雙側(cè)顳上回、中央前回,中央后回等。正常組較語前聾組增加激活的區(qū)域有右側(cè)腦島、顳極等,減少激活的有雙側(cè)中央后回、中央前回、枕下回等。正常組較語后聾組增加激活的區(qū)域有左側(cè)顳中回、顳下回等,減少激活的有額上回、中央前回等。語前聾組較語后聾組增加激活的區(qū)域有右側(cè)額下回、腦島等,減少激活的區(qū)域有側(cè)額中回、右側(cè)顳上回、緣上回等。結(jié)論1.靜息態(tài)fMRI成像方法可以有效地觀察正常人大腦的功能連接情況和耳聾患者聽覺皮層的功能重組變化,并且具有空間時間分辨率好、操作簡便、無侵襲性等優(yōu)點,適合運用于臨床研究。2.與正常聽力者對比,語后聾患者雙側(cè)聽覺皮層之間連接減少,聽覺皮層與軀體感覺運動皮層、語言相關(guān)皮層的連接增強。3.與正常聽力者對比,語前聾患者雙側(cè)聽覺皮層之間連接減少,聽覺皮層與軀體感覺運動皮層、視覺皮層的連接增強。4.與語后聾對比,語前聾聽覺皮層與軀體感覺運動皮層的連接增強更顯著。
[Abstract]:Objective and significance auditory cortex is an advanced center of hearing located in superior temporal gyrus and transverse temporal gyrus. The main function of auditory cortex is to process auditory afferent information. After the onset of deafness, the auditory cortex will undergo functional reorganization and participate in the processing of other non-auditory information, but the recombination pattern of prelingual deafness and postlingual deafness is different. We observed the auditory cortical remodeling patterns of different types of severe sensorineural hearing loss in adults with resting functional magnetic resonance (fMRI) functional junctions, and understood the characteristics of auditory central remodeling in prelingual and postlingual deafness. To provide the basis for its further intervention and treatment. Methods from March 2016 to November 2016, 20 adult patients with bilateral severe sensorineural deafness were selected, including 10 prelingual deafness, 10 postverbal deafness and 20 normal hearing. A 3.0T superconducting magnetic resonance machine was used to scan the conventional T1WIN T2WIT2-flair sequence and then the rest fMRI scan and the structural image scanning were performed. The data were preprocessed and the bilateral primary auditory cortex was selected as the seed point. The brain functional imaging performance of the three groups was analyzed by resting fMRI functional connection method. The data of the three groups were tested by single sample t test. The independent sample t test and Alphasim correction were used in the comparison between the two groups. The threshold values were P0.01 and P0.05, and the minimum significant activation numbers were K18 and K85respectively. Results when the left and right BA41 regions were used as seed points respectively, the positive activated brain regions in the normal group mainly included bilateral superior temporal gyrus, cerebral island, anterior cingulate gyrus, auxiliary motor area and so on. In the prelingual deafness group, the active brain regions mainly included bilateral superior temporal gyrus, cerebral island, anterior cingulate gyrus, posterior central gyrus, precentral gyrus and inferior occipital gyrus. The positive activated brain regions in postlingual deafness group included bilateral supratemporal gyrus, precentral gyrus and postcentral gyrus. In the normal group, the activation was increased in the right cerebral island, temporal pole, bilateral posterior central gyrus, precentral gyrus and inferior occipital gyrus. In the normal group, the areas of increased activation were left middle temporal gyrus, inferior temporal gyrus, suprafrontal gyrus, precentral gyrus and so on. The increased activation in prelingual deafness group compared with postverbal deafness group included right inferior frontal gyrus, cerebral island and so on. The reduced activation areas included lateral middle frontal gyrus, right superior temporal gyrus, superior marginal gyrus, and so on. Conclusion 1. Resting fMRI imaging can effectively observe the functional connections of the normal brain and the functional recombination of the auditory cortex in deafness patients, and has the advantages of good spatial and temporal resolution, simple operation, no invasion, and so on. Suitable for clinical research. 2. Compared with normal hearing, the connection between bilateral auditory cortex and somatosensory motor cortex and language-related cortex in postlingual deafness patients was decreased, and the connection between auditory cortex and somatosensory motor cortex was enhanced. Compared with normal hearing, the connection between bilateral auditory cortex and somatosensory motor cortex and visual cortex was decreased in prelingual deafness patients. Compared with postlingual deafness, the connection between auditory cortex and somatosensory motor cortex was significantly enhanced.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R764.43;R445.2
[Abstract]:Objective and significance auditory cortex is an advanced center of hearing located in superior temporal gyrus and transverse temporal gyrus. The main function of auditory cortex is to process auditory afferent information. After the onset of deafness, the auditory cortex will undergo functional reorganization and participate in the processing of other non-auditory information, but the recombination pattern of prelingual deafness and postlingual deafness is different. We observed the auditory cortical remodeling patterns of different types of severe sensorineural hearing loss in adults with resting functional magnetic resonance (fMRI) functional junctions, and understood the characteristics of auditory central remodeling in prelingual and postlingual deafness. To provide the basis for its further intervention and treatment. Methods from March 2016 to November 2016, 20 adult patients with bilateral severe sensorineural deafness were selected, including 10 prelingual deafness, 10 postverbal deafness and 20 normal hearing. A 3.0T superconducting magnetic resonance machine was used to scan the conventional T1WIN T2WIT2-flair sequence and then the rest fMRI scan and the structural image scanning were performed. The data were preprocessed and the bilateral primary auditory cortex was selected as the seed point. The brain functional imaging performance of the three groups was analyzed by resting fMRI functional connection method. The data of the three groups were tested by single sample t test. The independent sample t test and Alphasim correction were used in the comparison between the two groups. The threshold values were P0.01 and P0.05, and the minimum significant activation numbers were K18 and K85respectively. Results when the left and right BA41 regions were used as seed points respectively, the positive activated brain regions in the normal group mainly included bilateral superior temporal gyrus, cerebral island, anterior cingulate gyrus, auxiliary motor area and so on. In the prelingual deafness group, the active brain regions mainly included bilateral superior temporal gyrus, cerebral island, anterior cingulate gyrus, posterior central gyrus, precentral gyrus and inferior occipital gyrus. The positive activated brain regions in postlingual deafness group included bilateral supratemporal gyrus, precentral gyrus and postcentral gyrus. In the normal group, the activation was increased in the right cerebral island, temporal pole, bilateral posterior central gyrus, precentral gyrus and inferior occipital gyrus. In the normal group, the areas of increased activation were left middle temporal gyrus, inferior temporal gyrus, suprafrontal gyrus, precentral gyrus and so on. The increased activation in prelingual deafness group compared with postverbal deafness group included right inferior frontal gyrus, cerebral island and so on. The reduced activation areas included lateral middle frontal gyrus, right superior temporal gyrus, superior marginal gyrus, and so on. Conclusion 1. Resting fMRI imaging can effectively observe the functional connections of the normal brain and the functional recombination of the auditory cortex in deafness patients, and has the advantages of good spatial and temporal resolution, simple operation, no invasion, and so on. Suitable for clinical research. 2. Compared with normal hearing, the connection between bilateral auditory cortex and somatosensory motor cortex and language-related cortex in postlingual deafness patients was decreased, and the connection between auditory cortex and somatosensory motor cortex was enhanced. Compared with normal hearing, the connection between bilateral auditory cortex and somatosensory motor cortex and visual cortex was decreased in prelingual deafness patients. Compared with postlingual deafness, the connection between auditory cortex and somatosensory motor cortex was significantly enhanced.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R764.43;R445.2
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