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目的采用静息态功能磁共振成像(rs-fMRI)技术,观察复发性孤立性视神经炎(RION)患者初级视觉皮层(V1)与全脑功能连接的改变。方法收集45例RION患者(RION组)及45名年龄、性别相匹配的健康志愿者(正常对照组)的临床资料,并行常规头部MRI及rs-fMRI,选取V1为种子点,采用统计参数图5(SPM5)分析其与全脑的功能连接,比较两组数据的差异,并将RION组功能连接异常的脑区与其视力、病程及认知功能评分(PASAT)进行相关性分析。结果与正常对照组相比,RION组左侧额中回、双侧枕叶舌回、右侧颞中回及右侧顶下小叶与V1的功能连接明显减低;双侧楔前叶、右侧额前回、左侧顶下小叶及右侧岛叶与V1的功能连接明显增强,且差异均有统计学意义(P均<0.01)。右侧顶下小叶及右侧额前回的功能连接异常与PASAT评分呈正相关;左侧额中回的功能连接异常与患者视力呈正相关。结论 rs-fMRI可检测出RION患者与V1区功能连接异常的脑区,并且显示与视力、病程及认知功能评分相关的脑区,可为临床探索RION功能连接异常提供客观依据。
Objective To investigate the changes of primary visual cortex (V1) and whole brain functional connectivity in patients with recurrent solitary optic neuritis (RION) by resting state functional magnetic resonance imaging (rs-fMRI). Methods The clinical data of 45 patients with RION (RION group) and 45 healthy volunteers (normal control group) were collected. The MRI and rs-fMRI were performed on the conventional head MRI. V1 was selected as the seed point, and the statistical parameters Figure 5 (SPM5) analysis of its functional connection with the whole brain, comparing the differences between the two groups of data, and RION group functional connection abnormal brain area and its visual acuity, duration and cognitive function score (PASAT) correlation analysis. Results Compared with the normal control group, the functional connection of left middle frontal gyrus, bilateral occipital lobe, right middle temporal gyrus and right parietal lobule to V1 was significantly reduced in RION group. The anterior frontal gyrus, left inferior parietal lobule and the right isle lobe and V1 functional connectivity was significantly enhanced, and the differences were statistically significant (P all <0.01). Right anterior parietal lobule and right frontal gyrus functional connectivity abnormalities and PASAT score was positively correlated; left frontal midbrain dysfunction and the patient’s visual acuity was positively correlated. Conclusion rs-fMRI can detect brain regions with abnormal functional connectivity in patients with RION and demonstrate the brain regions associated with visual acuity, duration of disease and cognitive function scores, which may provide an objective basis for clinical exploration of functional abnormalities in RION.