【摘要】：【目的】 研究非癡呆型血管性認知障礙(Vascularcognitiveimpairmentnodementia,VCIND)前扣帶回神經(jīng)網(wǎng)絡(luò)的異常改變及其與MOCA的相關(guān)性，探討對VCIND的認知具有潛在臨床預(yù)測價值的腦區(qū)。 【方法】 1．采用MOCA量表對14例VCIND患者（入選標準：右利手，45~80歲，小學文化及以上，MRI檢查明確的皮層下缺血性腦血管病患者，北京版MOCA26分；排除標準：可能導致認知障礙的全身性疾病，可能導致認知障礙的神經(jīng)疾病，抑郁癥和精神病患者，有酒精或藥物濫用、化學物品中毒等有可能干擾研究的疾病，有失語、視聽障礙等妨礙評估進行的軀體功能缺陷）和16例健康老年人（對照組）的認知功能進行調(diào)查分析。 2．采用靜息態(tài)磁共振功能連接的方法繪制所有被試的前扣帶回神經(jīng)網(wǎng)絡(luò)模式特征。 3．將VCIND患者前扣帶回功能連接的強度與MOCA進行相關(guān)分析。 【結(jié)果】 1．VCIND組的MoCA總分、視空間/執(zhí)行功能、注意力/計算力、語言、定向力亞項顯著低于正常對照組（p0.05）；抽象能力/記憶力、命名亞項在兩組之間無明顯統(tǒng)計學差異（p0.05）。 2．VCIND組前扣帶回與全腦功能連接低于正常對照組的腦區(qū)有：左側(cè)顳中回/顳上回、額上回/額中回/額下回、后扣帶皮層/楔前葉、頂下小葉/角回，右側(cè)顳中回/顳上回、眶額回/額下回、頂下小葉/角回、額上回/額中回；VCIND組前扣帶回與全腦功能連接高于正常對照組的腦區(qū)有：右小腦后葉，距狀裂，左額中回、左中央前回。 3．VCIND組前扣帶回的功能連接強度與MOCA呈正相關(guān)的腦區(qū)：左頂下小葉、右側(cè)顳中回、右額上回、左側(cè)顳上回；呈負相關(guān)的腦區(qū)：右內(nèi)囊后肢、左楔前葉、左顳中回、右內(nèi)囊前肢。 【結(jié)論】 1．VCIND患者存在執(zhí)行功能、注意力、語言等多項認知障礙。 2．VCIND患者在靜息狀態(tài)下表現(xiàn)出異常的前扣帶回神經(jīng)網(wǎng)絡(luò)改變，，尤其默認網(wǎng)絡(luò)存在明顯異常。 3．左頂下小葉、右額上回等腦區(qū)與ACC的功能連接異常對VCIND的認知具有潛在的臨床預(yù)測價值。
[Abstract]:[objective] to study the abnormal changes of anterior cingulate gyrus neural network in non-dementia vascular cognitive impairment (Vascularcognitiveimpairmentnodementia,VCIND) and its correlation with MOCA, and to explore the brain regions which have potential clinical predictive value for the cognition of VCIND. [methods] 1. 14 patients with VCIND were selected with MOCA scale (right hand, 45 years old, primary school culture and above, MRI score of subcortical ischemic cerebrovascular disease, Beijing version of MOCA26). Exclusion criteria: systemic diseases that may lead to cognitive impairment, neurological diseases that may lead to cognitive impairment, depression and mental illness, diseases such as alcohol or drug abuse, chemical poisoning, which may interfere with the study, and aphasia. The cognitive function of 16 healthy elderly (control group) and 16 healthy elderly (control group) were investigated and analyzed. 2. The neural network characteristics of anterior cingulate gyrus were drawn by resting magnetic resonance functional connection. 3. The intensity of anterior cingulate function connection in patients with VCIND was correlated with MOCA. [results] the total score of MoCA, visual space / executive function, attention / computational power, language and orientation subitems in 1.VCIND group were significantly lower than those in normal control group (p0.05). There was no significant difference in abstract ability / memory and naming subitems between the two groups (p0.05). The connection between anterior cingulate gyrus and whole brain function in 2.VCIND group was lower than that in normal control group: left middle temporal gyrus / superior temporal gyrus, superior frontalis / middle frontalis / inferior frontalis, posterior cingulate cortex / anterior cuneiform lobe, inferior parietal lobule / angular gyrus, right middle temporal gyrus / superior temporal gyrus. Orbital / inferior frontalis, inferior parietal lobule / angular gyrus, superior frontalis / middle frontalis; The connections between anterior cingulate gyrus and whole brain function in VCIND group were higher than those in normal control group, including posterior lobe of right cerebellum, talus, left middle forehead gyrus and left anterior central gyrus. In 3.VCIND group, the functional connection intensity of anterior cingulate gyrus was positively correlated with MOCA: left inferior parietal lobule, right middle temporal gyrus, right superior forehead gyrus, left superior temporal gyrus; There was a negative correlation between the right internal capsule hindlimb, the left anterior cuneiform lobe, the left middle temporal gyrus and the right internal capsule forelimb. [conclusion] 1.VCIND patients have many cognitive impairment, such as executive function, attention, language and so on. 2.VCIND patients showed abnormal anterior cingulate neural network changes in resting state, especially the default network was significantly abnormal. 3. The abnormal functional connection between the left inferior parietal lobule and the right superior frontal gyrus and ACC has potential clinical predictive value for the cognition of VCIND.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R749.1;R445.2

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