發(fā)布時(shí)間：2018-04-14 05:06

  本文選題：血管性輕度認(rèn)知障礙 + 靜息態(tài)功能磁共振��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:利用靜息態(tài)功能磁共振成像(Rs-f MRI)技術(shù),探討血管性輕度認(rèn)知障礙(Va MCI)患者靜息態(tài)腦默認(rèn)網(wǎng)絡(luò)(DMN)的后扣帶回功能連接(FC)和不同頻段下比率低頻振幅(f ALFF)的變化特點(diǎn)及其與認(rèn)知功能的相關(guān)性。方法:選取2016年07月至2017年02月在山西醫(yī)科大學(xué)附屬第二醫(yī)院神經(jīng)內(nèi)科門(mén)診、住院部患者及體檢中心健康體檢者,22例Va MCI患者作為試驗(yàn)組,21名性別、年齡和受教育程度相匹配的認(rèn)知功能正常者作為對(duì)照組。以上兩組均行基于血氧水平依賴(BOLD)的Rs-f MRI掃描,比較兩組受試者感興趣區(qū)后扣帶回(PCC)與其他腦區(qū)的FC差異及在經(jīng)典頻段(0.01-0.08Hz)、slow-5亞頻段(0.01-0.027Hz)和slow-4亞頻段(0.027-0.073Hz)下的f ALFF差異,明確Va MCI患者的DMN變化特點(diǎn),并分析Va MCI組的蒙特利爾認(rèn)知評(píng)估(Mo CA)量表的評(píng)分分值與FC值、f ALFF值的關(guān)系。結(jié)果:1.Va MCI組的MMSE總分(25.55±1.92)、Mo CA總分(18.59±3.63)以及Mo CA亞項(xiàng)中的視空間與執(zhí)行功能(2.59±1.09)、注意力與計(jì)算力(2.77±0.92)、語(yǔ)言(1.5±1.06)、抽象力(0.23±0.43)及延遲回憶(3.23±1.15)亞項(xiàng)的得分都明顯低于認(rèn)知正常對(duì)照組(28.29±0.96、27.71±1.06、4.05±0.59、5.86±0.36、2.81±0.41、1.81±0.41、4.24±0.94),差異有統(tǒng)計(jì)學(xué)意義(P0.05);Mo CA亞項(xiàng)中的命名(2.63±0.58)及定向力(5.18±1.22)亞項(xiàng)與對(duì)照組相比(2.71±0.56、5.86±0.36),差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2.兩組組內(nèi)分析表明Va MCI組和對(duì)照組都存在廣泛FC及f ALFF值升高的腦區(qū),包括后扣帶回(PCC)、楔前葉(PCu)、頂下小葉(IPL)等腦區(qū)。其PCC、PCu在兩組中的FC及f ALFF值最高。3.Va MCI組與對(duì)照組相比較,顱內(nèi)存在廣泛的DMN變化:(1)Va MCI組后扣帶回與全腦FC強(qiáng)度低于對(duì)照組的腦區(qū)包括前扣帶回(ACC)、右/左側(cè)眶部額中回、左側(cè)顳下回,未發(fā)現(xiàn)FC明顯升高的腦區(qū)。(2)經(jīng)典頻段(0.01-0.08Hz)的f ALFF變化:右側(cè)楔前葉及右側(cè)顳上回的f ALFF值下降;左側(cè)眶部額下回及左側(cè)顳下回的f ALFF值增高。(3)亞頻段的f ALFF:在slow-5亞頻段右側(cè)顳下回、雙側(cè)小腦及左側(cè)角回的f ALFF值下降;在右側(cè)舌回及左側(cè)顳上回的f ALFF值升高;在slow-4亞頻段左側(cè)頂上小葉、左側(cè)背外側(cè)額上回及左側(cè)顳下回的f ALFF值下降;在右側(cè)顳上回及右側(cè)島葉的f ALFF值增高。4.Va MCI組異常DMN與Mo CA評(píng)分的相關(guān)性:在slow-5亞頻段,左側(cè)角回f ALFF值與Mo CA評(píng)分呈正相關(guān),其他DMN異常腦區(qū)的FC值及f ALFF值與Mo CA評(píng)分未發(fā)現(xiàn)明顯的相關(guān)性。結(jié)論:1.Va MCI患者在靜息態(tài)下表現(xiàn)出異常的后扣帶回功能連接模式。2.Va MCI患者腦默認(rèn)網(wǎng)絡(luò)存在異常的自發(fā)活動(dòng)改變,且Va MCI患者異�；顒�(dòng)的腦區(qū)在不同頻段下有不同的異常自發(fā)活動(dòng)的空間分布特征;3.在slow-5亞頻段左側(cè)角回異常的自發(fā)活動(dòng)變化與Mo CA評(píng)分呈正相關(guān),這一發(fā)現(xiàn)可為Va MCI的臨床診斷提供功能影像學(xué)的依據(jù)。
[Abstract]:Objective: to use resting functional magnetic resonance imaging (Rs-f MRI) technique.To investigate the changes of posterior cingulate functional junction (FCC) of resting brain default network (DMN) in patients with mild vascular cognitive impairment (Va MCI) and its correlation with cognitive function in patients with Va MCI.Methods: from July 2016 to February 2017, 22 patients with Va MCI in the Department of Neurology, the second affiliated Hospital of Shanxi Medical University were selected as the experimental group.Those with normal cognitive function matched with age and education level served as control group.Both groups underwent Rs-f MRI scanning based on blood oxygen level dependent (Bod). The difference of FC in the posterior cingulate gyrus of the region of interest between the two groups and the difference of f ALFF in the classical frequency range 0.01-0.08Hzslow-5 subband and slow-4 subband 0.027-0.073Hz) were compared between the two groups.To determine the characteristics of DMN changes in patients with Va MCI, and to analyze the relationship between the score of the Montreal Cognitive Assessment scale (MCA) and the value of FC / F ALFF in the Va MCI group.Results in the Va MCI group, the total score of MMSE was 25.55 鹵1.92mCA (18.59 鹵3.63), the visual space and executive function in the subitem of Mo CA was 2.59 鹵1.09g, the attention and computational power was 2.77 鹵0.92g, the language was 1.5 鹵1.06C, the abstract ability was 0.23 鹵0.43) and the subitems of delayed recall were significantly lower than those in the normal cognitive control group (28.29 鹵0.96n 27.71 鹵1.064.05 鹵0.595.86 鹵0.362.81 鹵0.362.81 鹵0.41.81 鹵0.41n 4.24 鹵0.944).The difference was statistically significant (P 0.05 鹵0.58) and orientation (5.18 鹵1.22) between the two subitems (2.71 鹵0.56N 5.86 鹵0.36g), no significant difference was found between the two subitems (P 0.05 鹵0.58) and P 0.05 鹵1.22 (P 0.05 鹵0.36), and there was no significant difference between the two subitems (P 0.05 鹵0.58) and orientation (5.18 鹵1.22).In both groups, both Va MCI group and control group showed extensive areas of increased FC and f ALFF, including posterior cingulate gyrus, anterior cuneate MCI, inferior parietal lobules, and so on.The FC and f ALFF values of the two groups were the highest. 3. Compared with the control group, there were extensive DMN changes in the intracranial area of the posterior cingulate gyrus and the whole brain FC intensity of the posterior cingulate gyrus and the whole brain of the Va MCI group, including the anterior cingulate gyrus, the middle frontal gyrus of the right / left orbital part, and the middle frontal gyrus of the right / left orbital part.In the left infratemporal gyrus, no significant increase in FC was found in the brain region. The changes of f ALFF in the classical frequency range of 0.01-0.08 Hz): the value of f ALFF in the right anterior cuneate lobe and the right superior temporal gyrus decreased;The f ALFF value of the left inferior frontal gyrus and left infratemporal gyrus was increased in the subband of slow-5. The f ALFF value of the bilateral cerebellum and the left angular gyrus decreased in the right inferior temporal gyrus of the slow-5 subband, and the f ALFF value in the right lingual gyrus and the left superior temporal gyrus was higher than that in the left superior temporal gyrus.The f ALFF value of left superior parietal lobe, left dorsolateral superior frontal gyrus and left infratemporal gyrus decreased in the subband of slow-4, and increased in the right superior temporal gyrus and right insular lobe. 4. The correlation between abnormal DMN and Mo CA score in the Va MCI group: in the slow-5 subband, there was no significant difference between f ALFF in the left superior dorsolateral frontal gyrus and the left inferior temporal gyrus.There was a positive correlation between left angle gyrus f ALFF value and Mo CA score, but no significant correlation between FC value and f ALFF value and Mo CA score in other abnormal brain regions of DMN.Conclusion: 1. The patients with Va MCI showed abnormal posterior cingulate functional connection pattern at rest. 2. There were abnormal spontaneous changes of brain network in patients with Va MCI.The spatial distribution of abnormal spontaneous activity in the brain region of patients with Va MCI was different at different frequencies.The spontaneous activity of abnormal left angular gyrus in the subband of slow-5 was positively correlated with the Mo CA score, which may provide functional imaging evidence for the clinical diagnosis of Va MCI.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R749.13

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本文編號(hào)：1747818