【摘要】：目的:通過對心理性ED患者腦白質(zhì)纖維的二值化和加權(quán)網(wǎng)絡(luò)節(jié)點度和連接強度拓撲屬性值的探討,分析不同腦區(qū)所連接白質(zhì)纖維髓鞘完整性、數(shù)目及其長度在拓撲空間上的改變情況。方法:采集21例心理性ED患者及性別、年齡、受教育程度相匹配的24例對照者的彌散張量成像數(shù)據(jù);對所有數(shù)據(jù)進行預(yù)處理,將整個大腦劃分為90個區(qū)域,追蹤全腦白質(zhì)纖維,構(gòu)建全腦白質(zhì)的二值化和加權(quán)網(wǎng)絡(luò),計算腦區(qū)的度和連接強度屬性值;對組間屬性值進行獨立雙樣本t檢驗,并對結(jié)果進行多重校正,將差異屬性值與患者陰莖勃起功能進行皮爾森相關(guān)分析。結(jié)果:1患者組腦白質(zhì)二值化網(wǎng)絡(luò)中左側(cè)三角部額下回(5.95±1.28,7.54±1.44,t=-3.88,P=0.02)、內(nèi)側(cè)眶部額上回(6.29±3.30,10.08±3.60,t=-3.67,P=0.02)、杏仁核(4.29±1.31,6.50±2.11,t=-4.16,P=0.01)度較對照組(均為校正后P值)顯著下降;2患者組基于FA值的腦白質(zhì)加權(quán)網(wǎng)絡(luò)中左側(cè)三角部額下回(1.72±0.50,2.50±0.68,t=-4.35,P=0.01)、內(nèi)側(cè)眶部額上回(2.08±1.10,3.17±0.97,t=-3.53,P=0.03)、杏仁核(1.11±0.39,1.80±0.69,t=-4.03,P=0.01)連接強度也均較對照組(均為校正后P值)顯著下降;3患者組基于FA值的腦白質(zhì)加權(quán)網(wǎng)絡(luò)中左側(cè)三角部額下回(1.72±0.50)、內(nèi)側(cè)眶部額上回(2.08±1.10)、杏仁核(1.11±0.39)連接強度也均較對照組(2.50±0.68,t=-4.35,P=0.01;3.17±0.97,t=-3.53,P=0.03;1.80±0.69,t=-4.03,P=0.01,校正后P值)顯著下降;4患者左側(cè)杏仁核度屬性值與勃起功能國際問卷總分(r=-0.47,P=0.04)、第2項評分(r=-0.46,P=0.03)以及第3項評分(r=-0.45,P=0.04)均呈負相關(guān)。結(jié)論:心理性ED患者左側(cè)部分額葉和杏仁核所連接的白質(zhì)纖維髓鞘完整性受損害,導(dǎo)致患者產(chǎn)生情緒、處理及調(diào)控的異常,另外患者左側(cè)杏仁核所連接的白質(zhì)纖維在大腦信息傳遞活動中的中心地位和重要性的下降可能與心理性ED相關(guān)。
[Abstract]:Objective: to analyze the myelin sheath integrity of white matter fibers connected in different brain regions by discussing the binarization of white matter fibers, the degree of nodes of weighted network and the topological attribute values of connection strength in patients with mental ED. The change of number and its length in topological space. Methods: diffusion Zhang Liang imaging data were collected from 21 patients with mental ED and 24 controls with matched sex, age and education level. All the data were preprocessed, the whole brain was divided into 90 regions, the white matter fibers of the whole brain were tracked, the binarization and weighted network of the white matter of the whole brain were constructed, and the degree of the brain area and the attribute value of the connection intensity were calculated. Independent double-sample t-test was performed among the groups and the results were corrected multiple times. Pearson correlation analysis was carried out between the difference attribute values and the erectile function of the penis of the patients. Results: 1in the patients group, the left inferior frontal gyrus (5.95 鹵1.28,7.54 鹵1.44, t = 3.88, P < 0.01) and the medial supraorbital gyrus (6.29 鹵3.30,10.08 鹵3.60, t = 3.67, P < 0.02) were found in the binarization network of the white matter in the left side of the brain, and in the left subfrontal gyrus (5.95 鹵1.28,7.54 鹵1.44, t = 3.88, P < 0.01). The degree of amygdala (4.29 鹵1.31, 6.50 鹵2.11, t = 4.16, P < 0.01) was significantly lower than that of the control group (P value after correction). 2in the patients group, the left inferior frontal gyrus (1.72 鹵0.50,2.50 鹵0.68, t = 4.35, P < 0.01) and the medial supraorbital gyrus (2.08 鹵1.10,3.17 鹵0.97, t = 3.53, P = 0.03) were based on FA value in the white matter weighted network in the left side of the brain, and the left inferior frontal gyrus (1.72 鹵0.50,2.50 鹵0.68, t = 4.35, P < 0.01). The connection strength of amygdala (1.11 鹵0.39, 1.80 鹵0.69, t = 4.03, P < 0.01) was significantly lower than that of the control group (P value after correction). 3The left inferior frontal gyrus (1.72 鹵0.50), medial orbital superior frontal gyrus (2.08 鹵1.10) and amygdala (1.11 鹵0.39) of the white matter weighted network based on FA in the patient group were also significantly stronger than those in the control group (2.50 鹵0.68,2.50 鹵0.68). T, 4.35, P < 0.01; 3.17 鹵0.97, t = 3.53, P = 0.03 鹵0.69, t = 4.03, P = 0.01 (P value after correction) decreased significantly; 4There was a negative correlation between the left amygdala degree and the total score of erectile function (r = 0.47, P < 0.04), the second score (r = 0.46, P = 0.03) and the third score (r = 0.45, P = 0.04). Conclusion: the myelin integrity of the white matter fibers connected to the left frontal lobe and amygdala in the patients with psychological ED is impaired, resulting in abnormal mood, management and regulation of the patients. In addition, the decrease in the central position and importance of the white matter fibers connected to the left amygdala in the brain information transmission may be related to psychological ED.
【作者單位】： 南京大學(xué)醫(yī)學(xué)院附屬鼓樓醫(yī)院男科;南京醫(yī)科大學(xué)附屬腦科醫(yī)院精神四科;東南大學(xué)學(xué)習(xí)科學(xué)研究中心;
【基金】：國家自然科學(xué)基金(81571430) 中央高�；究蒲袠I(yè)務(wù)費專項資金資助(021414380134)~~
【分類號】：R698.1

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