屈光參差性弱視兒童視覺運動功能損害的功能磁共振成像研究
發(fā)布時間：2018-08-29 15:03
【摘要】：[目的]利用血氧水平依賴性功能磁共振成像(BOLD-fMRI)技術(shù)對屈光參差性弱視兒童在視覺運動刺激時大腦皮層反應(yīng)進(jìn)行觀察,研究屈光參差性弱視的視覺運動功能受到的影響,分析皮層激活改變與視力損害間的可能關(guān)系。 [方法]采用BOLD-fMRI技術(shù)及組塊設(shè)計模式,以1.5T磁共振成像系統(tǒng)掃描圖像獲取數(shù)據(jù)。實驗刺激程序采用神經(jīng)心理學(xué)編程軟件"Presention"。刺激任務(wù)為注視水平左向、右向移動垂直正弦光柵,空間頻率為5cycle/degree(c/d),移動速度為4°/sec,對比度為50%,周邊對比度逐漸減低以消除明顯的邊緣,基底任務(wù)為注視固定于刺激屏中央的白色“+”點。從我院眼科門診連續(xù)抽取屈光參差性弱視組患者25例,剔除頭動與運動偽影后,共20例,其中男11例,女9例,年齡6-15歲；正常對照組25例,剔除頭動與運動偽影后,共23例,其中男11例,女12例,年齡6-14歲。實驗前均行散瞳驗光及試鏡,實驗組與對照組均無其它嚴(yán)重眼部疾病及神經(jīng)系統(tǒng)疾病,無全身疾病史。BOLD數(shù)據(jù)采集采用EPI (Echo Planar Imaging)序列,三維解剖圖像采集采用3D-FSPGR序列作矢狀位薄層掃描。受試者完成視覺任務(wù)及數(shù)據(jù)采集后,應(yīng)用AFNI、Matlab、SPM5軟件進(jìn)行數(shù)據(jù)處理和統(tǒng)計分析。預(yù)處理包括時間矯正、頭動矯正、空間標(biāo)準(zhǔn)化及三維空間平滑處理等。經(jīng)過預(yù)處理后,對符合要求的受試者數(shù)據(jù)進(jìn)行統(tǒng)計分析。通過時間信號強(qiáng)度曲線的相關(guān)分析來判斷與刺激和對照任務(wù)之間差異直接相關(guān)的激活區(qū)。然后對資料進(jìn)行像素水平的t檢驗,篩選腦激活區(qū)。分析包括：1、對正常對照組左、右眼間刺激進(jìn)行SPM5基本模型配對t檢驗。2、對屈光參差性弱視組的弱視眼、對側(cè)眼及正常對照組左眼、右眼進(jìn)行組分析,獲取平均激活圖。3、對屈光參差性弱視兒童的弱視眼、對側(cè)眼和對照組刺激腦激活區(qū)及激活強(qiáng)度分別進(jìn)行組間比較。4、弱視眼皮層神經(jīng)元損害情況與視力損害情況的關(guān)系。 [結(jié)果]①正常對照組左、右眼刺激激活最明顯的區(qū)域為中顳區(qū)(MT區(qū))、Brodmann37和19區(qū)即中、下顳葉及中枕葉,其次為Brodmann17區(qū)、18區(qū)即舌回、楔狀回、楔前葉皮層,此外尚有小腦后葉、頂上小葉等激活區(qū)。②正常對照組單眼刺激分析中引起視覺皮層反應(yīng)的優(yōu)勢大腦半球均為右側(cè),同一個個體的左眼、右眼的優(yōu)勢半球一致；③屈光參差性弱視兒童弱視眼較正常對照組在中顳區(qū)(MT區(qū))、Brodmann17、18、19、37區(qū)激活強(qiáng)度均減少,但以中顳區(qū)(MT區(qū))、Brodmann 19、37區(qū)減少顯著,顳中回、枕中回、舌回為低于正常對照的主要腦區(qū),與正常對照組相比額葉有較大范圍激活；④屈光參差性弱視對側(cè)眼較正常對照組在Brodmann37、18、19區(qū)激活強(qiáng)度均有所減少,但以Brodmann 37、18區(qū)減少顯著,而顳中回、楔葉、舌回為低于正常對照的主要腦區(qū)；⑤兩眼間比較,弱視眼較對側(cè)眼在中顳區(qū)(MT區(qū))和Brodmann19區(qū)、18區(qū)為主要激活體積及強(qiáng)度減少區(qū),而Brodmann17區(qū)和37區(qū)未見顯著性差異,顳中回、楔葉為低于對側(cè)眼的主要腦區(qū),額中回為弱視眼較對側(cè)眼主要增強(qiáng)腦區(qū)；⑥弱視眼的視力損害程度與皮層視覺運動功能的損害程度并不同步。 [結(jié)論]1、視覺運動功能皮層主要定位于Brodmann37、39及19區(qū)交界處的中顳區(qū)(MT),同時枕葉、頂葉部分腦區(qū)亦參與視覺運動信號的反應(yīng)。 2、屈光參差性弱視兒童視覺運動功能皮層BOLD-fMRI信號異常表現(xiàn)為腦皮層激活區(qū)體積和強(qiáng)度較正常兒童明顯下降,非弱視眼亦存在顯著性異常。 3、單眼視覺運動刺激時,弱視眼有更多的腦區(qū)參與反應(yīng)。 4、視力與皮層BOLD-fMRI信號強(qiáng)度無相關(guān)性,與視覺運動刺激相關(guān)功能皮層BOLD-fMRI信號的產(chǎn)生機(jī)制仍需深入探討。 5、水平運動光柵形成的生理刺激,除具有單純光感覺外,還具有視覺運動的成分。fMRI能直視視覺皮質(zhì)的活動情況,可用于探索弱視的病理生理基礎(chǔ)。
[Abstract]:[Objective] To investigate the effects of visual motor function in anisometropic amblyopia and the possible relationship between cortical activation and visual impairment by using blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI).
[Methods] BOLD-fMRI technique and block design pattern were used to obtain data from 1.5T MRI scanned images. Neuropsychological programming software "Presention" was used in the stimulus program. The stimulus task was to move the vertical sinusoidal grating horizontally to the left and to the right. The spatial frequency was 5 cycle/degree (c/d), the moving speed was 4 [sec] and the contrast was 4 [sec]. Fifty percent of the patients in the anisometropic amblyopia group were selected from the ophthalmic clinic of our hospital. After removal of head movement and motion artifacts, a total of 20 patients, including 11 males and 9 females, aged 6-15 years, were removed. After head movement and motion artifacts, 23 patients, including 11 males and 12 females, aged 6-14 years, underwent mydriatic optometry and examination before the experiment. There were no other serious ocular and nervous system diseases and no history of systemic diseases in both the experimental group and the control group. BOLD data were collected by EPI (Echo Planar Imaging) sequence and 3D-FSPGR sequence. After the visual task and data acquisition, the subjects were processed and analyzed by AFNI, MATLAB and SPM5 software. The pretreatment included time correction, head movement correction, spatial standardization and three-dimensional spatial smoothing. Correlation analysis of time signal intensity curves was used to determine the activation regions directly related to the differences between stimuli and control tasks. Then t-test was performed at pixel level to screen the brain activation regions. Visual eye, contralateral eye and normal control group, left eye and right eye were analyzed, and the average activation map was obtained. 3. The activation area and activation intensity of the stimulation brain in amblyopic children with anisometropic amblyopia, contralateral eye and control group were compared. 4. The relationship between the damage of cortical neurons and visual impairment in amblyopia.
[Results] In the normal control group, the most obvious activation areas of left and right eye stimulation were middle temporal area (MT area), Brodmann 37 and 19 were middle, inferior temporal lobe and middle occipital lobe, followed by Brodmann 17, 18 were lingual gyrus, cuneiform gyrus, anterior cuneiform lobe cortex, and there were also activation areas of posterior cerebellum and parietal lobe. The dominant cerebral hemisphere of cortical response was right side, the same individual left eye, the dominant right eye hemisphere was the same; (3) The activation intensity of anisometropic amblyopia in the middle temporal area (MT area), Brodmann 17, 18, 19, 37 area decreased significantly in the middle temporal area (MT area), Brodmann 19, 37 area, middle temporal gyrus, occipital gyrus, tongue compared with the normal control group. (4) The activation intensity of the contralateral eye in anisometropic amblyopia was lower than that in the normal control group in Brodmann 37,18,19 area, but the activation intensity in Brodmann 37,18 area was significantly lower than that in the normal control group, while in the middle temporal gyrus, cuneiform lobe and lingual gyrus were lower than that in the normal control group. Compared with the contralateral eyes, the amblyopic eyes were mainly in the middle temporal area (MT area) and Brodmann 19 area, and the 18 area was the main area of reduced activation volume and intensity, while the Brodmann 17 area and 37 area had no significant difference. The degree of damage is not synchronous with the impairment of cortical visual motor function.
[Conclusion] 1. The visual motor cortex is mainly located in the middle temporal region (MT) at the junction of Brodmann 37, 39 and 19. The occipital and parietal lobes are also involved in the visual motor response.
2. The abnormal BOLD-fMRI signals in the visual motor cortex of anisometropic amblyopia children showed that the volume and intensity of cortical activation areas were significantly decreased compared with normal children, and there were also significant abnormalities in non-amblyopic eyes.
3, in monocular visual stimulation, there are more brain regions in the amblyopic eye.
4. There is no correlation between visual acuity and cortical BOLD-fMRI signal intensity. The mechanism of BOLD-fMRI signal production in cortex related to visual motor stimulation needs further study.
5. The physiological stimulus formed by horizontal motion grating has not only simple light sensation, but also visual movement component. fMRI can see the activity of visual cortex directly and can be used to explore the pathophysiological basis of amblyopia.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R777.44
本文編號：2211568
[Abstract]:[Objective] To investigate the effects of visual motor function in anisometropic amblyopia and the possible relationship between cortical activation and visual impairment by using blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI).
[Methods] BOLD-fMRI technique and block design pattern were used to obtain data from 1.5T MRI scanned images. Neuropsychological programming software "Presention" was used in the stimulus program. The stimulus task was to move the vertical sinusoidal grating horizontally to the left and to the right. The spatial frequency was 5 cycle/degree (c/d), the moving speed was 4 [sec] and the contrast was 4 [sec]. Fifty percent of the patients in the anisometropic amblyopia group were selected from the ophthalmic clinic of our hospital. After removal of head movement and motion artifacts, a total of 20 patients, including 11 males and 9 females, aged 6-15 years, were removed. After head movement and motion artifacts, 23 patients, including 11 males and 12 females, aged 6-14 years, underwent mydriatic optometry and examination before the experiment. There were no other serious ocular and nervous system diseases and no history of systemic diseases in both the experimental group and the control group. BOLD data were collected by EPI (Echo Planar Imaging) sequence and 3D-FSPGR sequence. After the visual task and data acquisition, the subjects were processed and analyzed by AFNI, MATLAB and SPM5 software. The pretreatment included time correction, head movement correction, spatial standardization and three-dimensional spatial smoothing. Correlation analysis of time signal intensity curves was used to determine the activation regions directly related to the differences between stimuli and control tasks. Then t-test was performed at pixel level to screen the brain activation regions. Visual eye, contralateral eye and normal control group, left eye and right eye were analyzed, and the average activation map was obtained. 3. The activation area and activation intensity of the stimulation brain in amblyopic children with anisometropic amblyopia, contralateral eye and control group were compared. 4. The relationship between the damage of cortical neurons and visual impairment in amblyopia.
[Results] In the normal control group, the most obvious activation areas of left and right eye stimulation were middle temporal area (MT area), Brodmann 37 and 19 were middle, inferior temporal lobe and middle occipital lobe, followed by Brodmann 17, 18 were lingual gyrus, cuneiform gyrus, anterior cuneiform lobe cortex, and there were also activation areas of posterior cerebellum and parietal lobe. The dominant cerebral hemisphere of cortical response was right side, the same individual left eye, the dominant right eye hemisphere was the same; (3) The activation intensity of anisometropic amblyopia in the middle temporal area (MT area), Brodmann 17, 18, 19, 37 area decreased significantly in the middle temporal area (MT area), Brodmann 19, 37 area, middle temporal gyrus, occipital gyrus, tongue compared with the normal control group. (4) The activation intensity of the contralateral eye in anisometropic amblyopia was lower than that in the normal control group in Brodmann 37,18,19 area, but the activation intensity in Brodmann 37,18 area was significantly lower than that in the normal control group, while in the middle temporal gyrus, cuneiform lobe and lingual gyrus were lower than that in the normal control group. Compared with the contralateral eyes, the amblyopic eyes were mainly in the middle temporal area (MT area) and Brodmann 19 area, and the 18 area was the main area of reduced activation volume and intensity, while the Brodmann 17 area and 37 area had no significant difference. The degree of damage is not synchronous with the impairment of cortical visual motor function.
[Conclusion] 1. The visual motor cortex is mainly located in the middle temporal region (MT) at the junction of Brodmann 37, 39 and 19. The occipital and parietal lobes are also involved in the visual motor response.
2. The abnormal BOLD-fMRI signals in the visual motor cortex of anisometropic amblyopia children showed that the volume and intensity of cortical activation areas were significantly decreased compared with normal children, and there were also significant abnormalities in non-amblyopic eyes.
3, in monocular visual stimulation, there are more brain regions in the amblyopic eye.
4. There is no correlation between visual acuity and cortical BOLD-fMRI signal intensity. The mechanism of BOLD-fMRI signal production in cortex related to visual motor stimulation needs further study.
5. The physiological stimulus formed by horizontal motion grating has not only simple light sensation, but also visual movement component. fMRI can see the activity of visual cortex directly and can be used to explore the pathophysiological basis of amblyopia.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R777.44
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 王健;李傳明;余瓊武;汪輝;周楊;謝兵;邱明國;翁旭初;;屈光參差性弱視患者皮層功能損害及其與視力損害關(guān)系的功能MRI研究[J];中華放射學(xué)雜志;2006年12期
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