李朋,马雪英,丁墩,张华文,张明.静息态fMRI观察终末期肾病患者大脑自发神经活动异常与认知障碍的相关性[J].中国医学影像技术,2018,34(11):1645~1649
静息态fMRI观察终末期肾病患者大脑自发神经活动异常与认知障碍的相关性
Resting-state fMRI observation on relationship between brain spontaneous neural activity and cognitive dysfunction in end-stage renal disease patients
投稿时间:2018-02-21  修订日期:2018-08-02
DOI:10.13929/j.1003-3289.201802088
中文关键词:  肾功能衰竭,慢性  透析  认知障碍  磁共振成像
英文关键词:Kidney failure, chronic  Dialysis  Cognition disorders  Magnetic resonance imaging
基金项目:陕西省自然科学基金重大基础研究项目(2017ZDJC-13)。
作者单位E-mail
李朋 西安交通大学第一附属医院医学影像科, 陕西 西安 710061
陕西省核工业二一五医院医学影像科, 陕西 咸阳 712021 
 
马雪英 西安交通大学第一附属医院医学影像科, 陕西 西安 710061  
丁墩 西安交通大学第一附属医院医学影像科, 陕西 西安 710061  
张华文 陕西省核工业二一五医院医学影像科, 陕西 咸阳 712021  
张明 西安交通大学第一附属医院医学影像科, 陕西 西安 710061 zmmri@163.com 
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中文摘要:
      目的 采用静息态fMRI(rs-fMRI)低频振荡振幅算法(ALFF)观察终末期肾病(ESRD)患者大脑自发神经活动改变及其与认知功能障碍的相关性。方法 对28例ESRD患者(ESRD组)和25名年龄、性别相匹配的健康志愿者(对照组)行rs-fMRI。对所有受试者均行蒙特利尔认知量表(MoCA)评估,并采集ESRD组患者血肌酐和尿素水平。以统计参数图(SPM 8)及REST 1.4软件分析2组受试者fMRI数据,得到平均ALFF图,获得组间ALFF值差异脑区,并提取其平均ALFF值。对ALEF值与MoCA评分及血肌酐、尿素氮水平进行Pearson相关分析。结果 ESRD组MoCA评分显著低于对照组(P=0.006)。与对照组比较,ESRD组双侧额中回、双侧额内侧回、右侧额上回、双侧楔前叶、双侧额下回、双侧尾状核、双侧扣带回、左侧枕中回和双侧颞中回平均ALFF值减低(P均<0.001,FDR校正),未见平均ALFF值增高脑区。ESRD患者左侧额中回(r=0.68,P<0.001,FDR校正)及左侧颞中回(r=0.59,P<0.001,FDR校正)平均ALFF值与MoCA评分呈正相关,ESRD组各差异脑区平均ALFF值与血肌酐、尿素水平均无明显相关性(P均>0.05)。结论 ESRD患者存在整体认知障碍,且与左侧额中回及颞中回自发脑功能异常密切相关,可为观察ESRD患者在维持性透析过程中的认知功能障碍提供影像学标记。
英文摘要:
      Objective To investigate the changes of spontaneous brain activity and the relationship with cognitive dysfunction in the end-stage renal disease (ESRD) patients using resting-state fMRI (rs-fMRI) with the amplitude of low-frequency fluctuation (ALFF) algorithm. Methods Totally 28 ESRD patients (ESRD group) and 25 age-and sex-matched healthy controls (control group) underwent rs-fMRI and Montreal Cognitive Assessment (MoCA). The laboratory tests, including serum creatinine and urea, were performed in all ESRD patients. SPM 8 and REST 1.4 software were used to process the data and generate all participants' mean ALFF maps. Two-sample t test was used to determine the mean ALFF differences between ESRD group and control group. In addition, the Pearson correlation analysis was used to evaluate the relationship between the brain regions with different mean ALFF value and the MoCA scores, serum creatinine and urea level. Results Compared with control group, MoCA scores in ESRD groups were significantly lower (P=0.006). The brain regions with significantly decreased mean ALFF value in ESRD group including bilateral middle frontal gyrus, bilateral medial frontal gyrus, right superior frontal gyrus, bilateral precuneus, bilateral inferior frontal gyrus, bilateral caudate, bilateral cingulate gyrus, left middle occipital gyrus and bilateral temporal gyrus (all P<0.001, FDR correction). No brain region with increased mean ALFF value was found. The mean ALFF value in left middle frontal gyrus (r=0.68, P<0.001, FDR correction) and left middle temporal gyrus (r=0.59, P<0.001, FDR correction) was positively correlated with MoCA scores of ESRD patients. No significant correlation was found between ALFF value of brain regions and serum creatinine nor urea level (all P>0.05). Conclusion Cognitive dysfunction in ESRD patients is closely correlated with the changes of spontaneous brain activity in left middle frontal gyrus and left middle temporal gyrus, which might provide imaging marker of brain function for hemodialysis ESRD patients.
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