李正然,常天静,王子璇,张玮艺,詹亚峰,刘勇,王春雪,沈慧聪.老年人脑白质病变相关性跌倒的脑静息态功能磁共振成像[J].中国医学影像技术,2016,32(11):1659~1663
老年人脑白质病变相关性跌倒的脑静息态功能磁共振成像
Resting state fMRI on white matter lesions in the aged with fall risk
投稿时间:2016-04-13  修订日期:2016-08-16
DOI:10.13929/j.1003-3289.2016.11.009
中文关键词:  白质  意外跌倒  静息态功能磁共振成像
英文关键词:White matter  Accidental falls  Resting state functional magnetic resonance imaging
基金项目:首都临床特色应用研究与成果推广(Z151100004015127)。
作者单位E-mail
李正然 首都医科大学附属北京天坛医院神经影像中心, 北京 100050  
常天静 首都医科大学附属北京天坛医院神经影像中心, 北京 100050  
王子璇 首都医科大学附属北京天坛医院神经精神医学与临床心理科, 北京 100050  
张玮艺 首都医科大学附属北京天坛医院神经精神医学与临床心理科, 北京 100050  
詹亚峰 南方医科大学生物医学工程学院, 广东 广州 510515
中国科学院自动化研究所脑网络组中心, 北京 100190 
 
刘勇 中国科学院自动化研究所脑网络组中心, 北京 100190  
王春雪 首都医科大学附属北京天坛医院神经精神医学与临床心理科, 北京 100050  
沈慧聪 首都医科大学附属北京天坛医院神经影像中心, 北京 100050 shenhuicong@126.com 
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中文摘要:
      目的 探讨老年人脑白质病变(WMLs)相关性跌倒患者的脑静息态fMRI(rs-fMRI)特征。方法 前瞻性选取本院60岁以上的WMLs患者40例,均接受rs-fMRI检查,根据Tinetti平衡和步态量表划分为跌倒风险组(Tinetti<25,n=11)及对照组(Tinetti≥25,n=29)。应用SPM 8软件进行图像处理,识别跌倒风险患者脑网络内及网络间的功能连接异常,并与简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分进行相关性分析。结果 跌倒风险组的MMSE(t=4.04,P<0.01)及MoCA(t=3.88,P<0.01)量表评分低于对照组。与对照组比较,跌倒风险组的记忆网络(MeN)脑功能连接减弱(t=2.87,P=0.01);带状盖任务控制网络(CON)和腹侧注意网络(VAN)的功能连接减弱(t=2.59,P =0.01);默认网络(DMN)和额顶任务控制网络(FPN)的功能连接增强(t=-2.13,P=0.04),所有WMLs患者的MeN网络内功能连接与MoCA评分(r=0.39,P=0.01)呈正相关;DMN和FPN功能连接与MMSE(r=-0.40,P=0.01)及MoCA(r=-0.37,P=0.02)呈负相关。结论 具有跌倒风险的WMLs患者存在脑网络内及网络间的功能连接异常,并与其认知功能改变存在一定的相关性。
英文摘要:
      Objective To analyze the resting state fMRI (rs-fMRI) characteristics in the aged who had white matter lesions (WMLs) with fall risks. Methods A total of 40 patients (age>60 years) with WMLs were enrolled in this prospective study.And all the patients were performed rs-fMRI. According to the Tinetti Balance and Gait Analysis, all patients were divided into experimental group (Tinetti<25, n=11) and contrast group (Tinetti≥25, n=29). SPM 8 software was used to analyze the data of rs-fMRI, and the abnormal functional connectivity was identified and made correlation analysis with montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) scores. Results There were statistical differences in the scores of MMSE (t=4.04, P<0.01) and MoCA (t=3.88, P<0.01) between two groups. Compared with control group, the intra-functional connectivity of memory retrieval (MeN) decreased in experimental group (t=2.87, P=0.01). The functional connectivity between cingulo-opercular control network (CON) and ventral attention network (VAN) decreased (t=2.59, P=0.01) and the functional connectivity between default mode network (DMN) and fronto-parietal task control network (FPN) increased (t=-2.13, P=0.04) in experimental group. The intra-functional connectivity of MeN in all the patients showed positive correlation with MoCA scores (r=0.39, P=0.01). And the functional connectivity of DMN and FPN showed negative correlation with MMSE scores (r=-0.40, P=0.01) and MoCA scores (r=-0.37, P=0.02). Conclusion In WMLs patients with fall risks, some intra-network and inter-network functional connectivities show significant differences, and these differences are correlated with cognitive performance scores.
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