復(fù)發(fā)緩解型多發(fā)性硬化患者在視覺結(jié)構(gòu)中的功能連接及結(jié)構(gòu)連接的研究
發(fā)布時(shí)間：2018-11-19 18:36
【摘要】：目的：應(yīng)用靜態(tài)功能連接磁共振(functional connectivity MRI,fcMRI)、彌散張量成像-纖維束示蹤(diffusion tensor imaging-fiber tractograph,DTI-FT)磁共振技術(shù)對(duì)復(fù)發(fā)-緩解型多發(fā)性硬化(relapsing remitting multiple sclerosis,RRMS)患者及正常人進(jìn)行初級(jí)視覺皮層（V1）的靜息態(tài)功能連接與初級(jí)視覺皮層及視放射結(jié)構(gòu)連接研究，探討RRMS患者視覺功能相關(guān)區(qū)域的功能與結(jié)構(gòu)的特征性改變以及兩者間的相互關(guān)系。 方法：收集2011.6-2013.12臨床確診的RRMS患者及性別、年齡及受教育程度相匹配的健康志愿者各20例。所有被試行3.0T磁共振顱腦掃描，獲取用于影像診斷的常規(guī)圖像及后處理功能圖像包括血氧水平依賴信號(hào)及彌散張量成像。記錄RRMS患者的病程、并進(jìn)行臨床預(yù)后參數(shù)擴(kuò)展殘疾量表、進(jìn)步式聽覺累加測(cè)試及修正的疲勞影響尺度評(píng)估。運(yùn)用DPARSF、SPM8、REST、TrackVis、DTI-Studio等軟件對(duì)數(shù)據(jù)進(jìn)行預(yù)處理和后處理，并分別獲得RRMS組和對(duì)照組（healthy controls，HCs）的初級(jí)視覺皮層功能連接數(shù)據(jù)、初級(jí)視覺皮層及視放射DTI參數(shù)（FA值、ADC值、λ∥及λ⊥），對(duì)所得數(shù)值進(jìn)行組間兩樣本及相關(guān)性統(tǒng)計(jì)學(xué)分析，差異閾值設(shè)為P 0.05。 結(jié)果： 1、RRMS患者M(jìn)FIS得分及EDSS得分均高于正常對(duì)照組，PASAT得分低于正常對(duì)照組。 2、與HCs相比，RRMS組V1與右側(cè)頂下小葉（brodmann’s area40，BA40）、右側(cè)額中回（BA46）及右側(cè)小腦與V1的功能連接明顯減弱（P 0.05，經(jīng)AlphaSim校正）；而與雙側(cè)前扣帶回（BA32）與V1的功能連接明顯增強(qiáng)（P 0.05，經(jīng)AlphaSim校正）。 3、與HCs相比，RRMS組患者初級(jí)視覺皮層ADC值明顯升高（t=3.056，P=0.004），λ∥明顯升高（t=2.523，P=0.016），λ⊥明顯升高（t=2.523，P=0.005），患者組視放射的FA值顯著降低（t=-2.405，P=0.021）。 4、RRMS患者組初級(jí)視覺皮層的ADC值與病程存在正相關(guān)性（r=0.539，P=0.014），λ∥與病程存在正相關(guān)性（r=0.514，P=0.020），λ⊥與病程存在正相關(guān)性（r=0.497，P=0.026）。RRMS患者組初級(jí)視覺皮層與視放射FA值之間無(wú)明顯相關(guān)性（P0.05）。 5、RRMS患者組功能連接異常腦區(qū)右側(cè)額中回與RRMS組初級(jí)視覺皮層λ⊥值呈負(fù)相關(guān)（r=-0.453，P=0.045），右側(cè)小腦半球（后葉）與初級(jí)視覺皮層λ∥（r=0.551，，P=0.012）、λ⊥（r=0.513，P=0.021）及ADC值（r=-0.559，P=0.010）呈正相關(guān)。 結(jié)論： 1、RRMS患者初級(jí)視覺皮層的結(jié)構(gòu)和功能連接存在異常，可能與患者存在潛在的視空間工作記憶功能障礙有關(guān)。 2、RRMS患者初級(jí)視覺皮層和視放射均存在結(jié)構(gòu)的損傷；兩者間損傷程度無(wú)相關(guān)性，提示初級(jí)視覺皮層與視放射之間的病理改變過程可能是獨(dú)立的。 3、RRMS患者中，病程越長(zhǎng)，大腦初級(jí)視覺皮層灰質(zhì)微觀結(jié)構(gòu)損傷程度越明顯；且初級(jí)視覺皮層的結(jié)構(gòu)改變與初級(jí)視覺皮層異常功能連接相關(guān)，推測(cè)初級(jí)視覺皮層結(jié)構(gòu)損害可能影響了視覺功能連接。
[Abstract]:Objective: to evaluate the application of static functional connective magnetic resonance (functional connectivity MRI,fcMRI) and diffusion-Zhang Liang imaging with tracer (diffusion tensor imaging-fiber tractograph,DTI-FT (diffusion tensor imaging-fiber tractograph,DTI-FT) in the treatment of relapse-remission multiple sclerosis (relapsing remitting multiple sclerosis,). The resting functional connections of primary visual cortex (V1) with primary visual cortex and visual radiation structure were studied in RRMS patients and normal subjects. Objective: to investigate the characteristic changes of function and structure of visual function related regions in patients with RRMS and the relationship between them. Methods: 20 patients with RRMS and 20 healthy volunteers with matched gender, age and education were collected from June to December 2011. All 3.0T MRI craniocerebral scans were used to obtain conventional images and post-processing functional images for imaging diagnosis, including blood oxygen level dependent signals and diffused Zhang Liang imaging. The course of RRMS was recorded, and the clinical prognostic parameters were evaluated by extended disability scale, progressive auditory cumulative test and modified fatigue impact scale. DPARSF,SPM8,REST,TrackVis,DTI-Studio and other software were used to preprocess and post-process the data. The primary visual cortex functional connection data, the primary visual cortex and visual radiation DTI parameters (FA) of the RRMS group and the control group (healthy controls,HCs) were obtained, respectively. The values of ADC, 位 / and 位 ~ (-) were analyzed by two samples and correlation statistical analysis. The threshold of difference was set as P0.05. Results: 1 the scores of MFIS and EDSS in RRMS patients were higher than those in the normal control group, and the PASAT scores were lower than those in the normal control group. 2Compared with HCs, the functional connections between V1 and right inferior parietal lobule (brodmann's area40,BA40), right middle frontal gyrus (BA46) and right cerebellum with V1 were significantly decreased in RRMS group (P 0.05, corrected by AlphaSim). The functional connection between the anterior cingulate gyrus (BA32) and V1 was significantly enhanced (P 0.05, corrected by AlphaSim). 3Compared with HCs, the ADC value of primary visual cortex in RRMS group was significantly higher than that in RRMS group (t = 3.056, P ~ (0.004), 位 _ (1) / (t _ (2.523) P _ (0. 016), 位 _ () was significantly increased (t _ (2.523) P ~ (0. 005). The FA value of visual radiation in the patients group was significantly lower than that in the control group (t = -2.405, P = 0.021). 4There was a positive correlation between the ADC value of the primary visual cortex and the course of disease in RRMS group (r = 0.539P0. 014), a positive correlation between 位 / and the course of the disease (r = 0. 514), and a positive correlation between the ADC value of the primary visual cortex and the course of disease (r = 0. 497, r = 0. 497). There was no significant correlation between FA value of primary visual cortex and visual radiation (P0.05) in group P ~ (0.026). 5There was a negative correlation between the right middle frontal gyrus in the right frontal gyrus and the primary visual cortex in the RRMS group (r = 0.453P ~ (0.045). The right cerebellar hemisphere (posterior lobe) and the primary visual cortex 位 / (r ~ (0.551P) 0.012) were found in the right cerebellar hemisphere (P < 0.05). There was a positive correlation between ADC value (r = 0.513, P = 0.021) and ADC value (r = 0.559, P = 0.010). Conclusion: 1 the abnormal structure and functional connection of primary visual cortex in RRMS patients may be related to the potential visual spatial working memory dysfunction. 2There were structural damage in primary visual cortex and visual radiation in RRMS patients, but there was no correlation between them, suggesting that the pathological process between primary visual cortex and visual radiation might be independent. 3 in RRMS patients, the longer the course of disease, the more obvious the microstructural damage of gray matter in the primary visual cortex of brain. The structural changes of the primary visual cortex were related to the abnormal functional connections of the primary visual cortex, which suggested that the damage of the primary visual cortex structure might affect the visual functional connections.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.2;R744.51
本文編號(hào)：2343088
[Abstract]:Objective: to evaluate the application of static functional connective magnetic resonance (functional connectivity MRI,fcMRI) and diffusion-Zhang Liang imaging with tracer (diffusion tensor imaging-fiber tractograph,DTI-FT (diffusion tensor imaging-fiber tractograph,DTI-FT) in the treatment of relapse-remission multiple sclerosis (relapsing remitting multiple sclerosis,). The resting functional connections of primary visual cortex (V1) with primary visual cortex and visual radiation structure were studied in RRMS patients and normal subjects. Objective: to investigate the characteristic changes of function and structure of visual function related regions in patients with RRMS and the relationship between them. Methods: 20 patients with RRMS and 20 healthy volunteers with matched gender, age and education were collected from June to December 2011. All 3.0T MRI craniocerebral scans were used to obtain conventional images and post-processing functional images for imaging diagnosis, including blood oxygen level dependent signals and diffused Zhang Liang imaging. The course of RRMS was recorded, and the clinical prognostic parameters were evaluated by extended disability scale, progressive auditory cumulative test and modified fatigue impact scale. DPARSF,SPM8,REST,TrackVis,DTI-Studio and other software were used to preprocess and post-process the data. The primary visual cortex functional connection data, the primary visual cortex and visual radiation DTI parameters (FA) of the RRMS group and the control group (healthy controls,HCs) were obtained, respectively. The values of ADC, 位 / and 位 ~ (-) were analyzed by two samples and correlation statistical analysis. The threshold of difference was set as P0.05. Results: 1 the scores of MFIS and EDSS in RRMS patients were higher than those in the normal control group, and the PASAT scores were lower than those in the normal control group. 2Compared with HCs, the functional connections between V1 and right inferior parietal lobule (brodmann's area40,BA40), right middle frontal gyrus (BA46) and right cerebellum with V1 were significantly decreased in RRMS group (P 0.05, corrected by AlphaSim). The functional connection between the anterior cingulate gyrus (BA32) and V1 was significantly enhanced (P 0.05, corrected by AlphaSim). 3Compared with HCs, the ADC value of primary visual cortex in RRMS group was significantly higher than that in RRMS group (t = 3.056, P ~ (0.004), 位 _ (1) / (t _ (2.523) P _ (0. 016), 位 _ () was significantly increased (t _ (2.523) P ~ (0. 005). The FA value of visual radiation in the patients group was significantly lower than that in the control group (t = -2.405, P = 0.021). 4There was a positive correlation between the ADC value of the primary visual cortex and the course of disease in RRMS group (r = 0.539P0. 014), a positive correlation between 位 / and the course of the disease (r = 0. 514), and a positive correlation between the ADC value of the primary visual cortex and the course of disease (r = 0. 497, r = 0. 497). There was no significant correlation between FA value of primary visual cortex and visual radiation (P0.05) in group P ~ (0.026). 5There was a negative correlation between the right middle frontal gyrus in the right frontal gyrus and the primary visual cortex in the RRMS group (r = 0.453P ~ (0.045). The right cerebellar hemisphere (posterior lobe) and the primary visual cortex 位 / (r ~ (0.551P) 0.012) were found in the right cerebellar hemisphere (P < 0.05). There was a positive correlation between ADC value (r = 0.513, P = 0.021) and ADC value (r = 0.559, P = 0.010). Conclusion: 1 the abnormal structure and functional connection of primary visual cortex in RRMS patients may be related to the potential visual spatial working memory dysfunction. 2There were structural damage in primary visual cortex and visual radiation in RRMS patients, but there was no correlation between them, suggesting that the pathological process between primary visual cortex and visual radiation might be independent. 3 in RRMS patients, the longer the course of disease, the more obvious the microstructural damage of gray matter in the primary visual cortex of brain. The structural changes of the primary visual cortex were related to the abnormal functional connections of the primary visual cortex, which suggested that the damage of the primary visual cortex structure might affect the visual functional connections.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R445.2;R744.51
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