本文選題：多發(fā)性硬化　切入點：海馬　出處：《南昌大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：聯(lián)合靜息態(tài)功能連接（resting-statefunctionalconnectivity，RSFC）、局部一致性（regional homogeneity，ReHo）和彌散張量成像纖維束示蹤（diffusiontensor imaging fiber tracking，DTI-FT）技術(shù)，分析復(fù)發(fā)緩解型多發(fā)性硬化(relapsingremitting multiple sclerosis，，RRMS)患者海馬與全腦功能連接、局部功能連接和結(jié)構(gòu)的改變，通過分析海馬內(nèi)源性功能活動、結(jié)構(gòu)和患者認(rèn)知功能的相關(guān)性，探究RRMS患者海馬改變的可能機(jī)理。 方法：招募24例RRMS患者與24名性別、年齡及受教育程度相匹配的健康志愿者進(jìn)行3.0T磁共振顱腦掃描，獲取常規(guī)磁共振（magnetic resonance imaging，MRI）圖像、血氧水平依賴信號功能磁共振圖像（functional MRI，fMRI）及DTI-FT數(shù)據(jù)。數(shù)據(jù)分析主要包括：(1)使用靜息態(tài)數(shù)據(jù)處理助手基于MATLAB平臺對靜息態(tài)fMRI數(shù)據(jù)進(jìn)行預(yù)處理，REST軟件提取雙側(cè)海馬為感興趣區(qū)，進(jìn)行種子為基礎(chǔ)的全腦功能連接分析，ReHo方法用于計算海馬內(nèi)部的局部功能連接；（2）Diffusion Toolkit軟件、Track Vis軟件提取雙側(cè)海馬區(qū)DTI參數(shù)（ADC值、FA值）。所有受試者接受臨床評分量表評估（EDSS、PASAT、MFIS）。RRMS與正常對照組（healthy controls，HCs）的一般情況、臨床評分及海馬區(qū)DTI相關(guān)參數(shù)（ADC值、FA值）使用SPSS軟件進(jìn)行組間兩樣本t檢驗，RSFC及ReHo值使用SPM8軟件進(jìn)行組間兩樣本t檢驗，患者組臨床評分量表、RSFC異常區(qū)域、ReHo異常區(qū)域、DTI參數(shù)兩兩間進(jìn)行Pearson相關(guān)性分析。 結(jié)果：（1）RRMS患者M(jìn)FIS得分(t=11.7, P=0.001)及EDSS得分均高于HCs，PASAT得分低于HCs（t=3.449, P=0.001）。 （2）與HCs比較，RRMS患者左側(cè)海馬與左側(cè)海馬旁回（brodmann area36，BA36）功能連接減弱，與左后側(cè)小腦、右側(cè)額中回（BA9）、右側(cè)額下回（BA47）、右側(cè)緣上回(BA40)功能連接增強(qiáng)；右側(cè)海馬與左后側(cè)小腦功能連接增強(qiáng)（P 0.05，經(jīng)AlphaSim校正，體素85）。 （3）與HCs比較，RRMS患者左側(cè)海馬頭部、尾部ReHo減弱（P 0.05，經(jīng)AlphaSim校正，體素10）。 （4）與HCs比較，RRMS患者左側(cè)海馬ADC值升高(t=3.147, P=0.004)，F(xiàn)A值減低(t=3.544,P=0.001)；HCs及RRMS患者組海馬ADC值與FA值存在明顯負(fù)性相關(guān)。 （5）左側(cè)海馬功能連接異常腦區(qū)中右側(cè)額中回與臨床量表PASAT得分（r=0.473, P=0.019）、左側(cè)海馬ADC值（r=-0.502, P=0.012）及FA值（r=0.477,P=0.019）均存在相關(guān)性，右側(cè)緣上回與左側(cè)海馬ADC值（r=-0.506，P=0.012）存在負(fù)性相關(guān)。左側(cè)海馬ADC值（r=-0.481, P=0.017）、FA值（r=0.438, P=0.032）與PASAT得分分別存在負(fù)性、正性相關(guān)。 結(jié)論：（1）RRMS患者海馬區(qū)存在與全腦和局部的異常功能連接，且異常功能連接與認(rèn)知功能相關(guān)。 （2）RRMS患者海馬存在結(jié)構(gòu)異常，且呈現(xiàn)左側(cè)大腦半球偏側(cè)化改變，左側(cè)海馬結(jié)構(gòu)損害與認(rèn)知功能相關(guān)。 （3）左側(cè)海馬結(jié)構(gòu)改變與左側(cè)海馬異常功能連接右側(cè)額中回、緣上回存在相關(guān)性，海馬結(jié)構(gòu)改變影響了海馬功能連接，進(jìn)而影響患者正常認(rèn)知功能，可能是造成RRMS患者認(rèn)知功能改變的機(jī)理之一。
[Abstract]:Objective: to study the hippocampal and global functional junctions in patients with relapsed multiple sclerosis (relapsing multiple sclerosis) using resting-statefunctive connectivity (RSFCs), regional homogeneity imaging (ReHoA) and diffusive Zhang Liang imaging fiber tracer imaging fiber tracking- DTI-FT- (DTI-FTT-FTIR) technique in patients with recurrent and remission multiple sclerosis (MS), and to analyze the functional connections between the hippocampus and the whole brain in patients with recurrent and remission multiple sclerosis (MS). By analyzing the correlation among endogenous functional activity, structure and cognitive function of patients with RRMS, the possible mechanism of hippocampal changes was explored. Methods: 24 patients with RRMS and 24 healthy volunteers matched with sex, age and education were recruited to perform 3.0T MRI brain scan, and routine magnetic resonance imaging images were obtained. Blood oxygen level dependent signal functional MRI of MRI) and DTI-FT data. Data analysis mainly includes: 1) using rest data processing assistant to preprocess resting fMRI data based on MATLAB platform and rest software to extract bilateral hippocampus as regions of interest. Seed-based global brain functional junction analysis was used to calculate the local functional junctions in the hippocampus. The track Vis software was used to extract bilateral hippocampal DTI parameters. All subjects received the clinical score scale. To assess the general status of EDSS PASAT MFISN. RRMS and healthy controls (HCs), Clinical score and DTI related parameters of hippocampus were evaluated by SPSS software and SPM8 software were used to carry out t-test of two samples between groups, and SPM8 software was used to test t-test of two samples between groups. The correlation of Pearson parameters in abnormal area of RSFC and abnormal area of ReHo was analyzed. Results the scores of MFIS and EDSS in the patients with RMS were higher than those in the patients with EDSS (P < 3.449, P < 0.001), and the scores of EDSS were higher than those of the patients with RMS (P < 0.001), and the scores of EDSS were significantly higher than those of the patients with RMS (P < 0.01). (2) compared with HCs, the functional connections of left hippocampal and left parahippocampal gyrus (Brodmann area36, BA36) decreased, and increased with left posterior cerebellum, right middle frontal gyrus, right inferior frontal gyrus, right inferior frontal gyrus, right superior margin gyrus, and right superior margin gyrus. The right hippocampus and left posterior cerebellar functional junction were enhanced P 0.05, corrected by AlphaSim. (3) compared with HCs, the left hippocampal head and tail ReHo of RRMS patients were attenuated P 0.05, corrected by AlphaSim. (4) compared with HCs, the ADC value of left hippocampus in RMS patients increased 3.147, the FA value decreased 3.544% in RRMS group and the ADC value in hippocampus in RRMS group was negatively correlated with FA value. (5) the right middle frontal gyrus in the left hippocampal functional junction was correlated with the PASAT scores (r = 0.473, P = 0.019), the ADC value of the left hippocampus (r = 0.502, P = 0.012) and the FA value (r = 0.477n, P = 0.019). There was a negative correlation between the right superior margin gyrus and the left hippocampal ADC value (r = 0.506). The left hippocampal ADC value was 0.481.The left hippocampal ADC value was 0. 438, P = 0. 032) and the PASAT score was positively correlated with that of the left hippocampal ADC value (P = 0. 017, P = 0. 038, P = 0. 032). Conclusion the hippocampal area of RRMS patients with RRMS has abnormal functional connections with the whole brain and local areas, and the abnormal functional connections are related to cognitive function. There were abnormal hippocampal structure in RRMS patients, and the left cerebral hemispheres were lateralized. The damage of left hippocampus structure was related to cognitive function. 3) the changes of left hippocampal structure and left hippocampal abnormal function connect right middle frontal gyrus and supramarginal gyrus. The changes of hippocampal structure affect the functional connection of hippocampus, and then affect the normal cognitive function of the patients. It may be one of the mechanisms of cognitive function change in patients with RRMS.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R744.51;R445.2

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相關(guān)期刊論文 前1條

1 鄭金甌;黨超;梁志堅;余璐;李麗萍;陳子蓉;葉偉;;顳葉癲癇患者執(zhí)行功能的功能磁共振研究[J];中國神經(jīng)精神疾病雜志;2011年03期

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