一氧化碳中毒后迟发性脑病患者的大脑结构网络损伤的扩散张量成像研究Study on brain structure network of patients with delayed encephalopathy after carbon monoxide poisoning: Based on diffusion tensor imaging
蒋雯茜;伍清宇;赵梓茹;王亮;周璐;李丹;何来昌;谭永明;
摘要(Abstract):
目的利用扩散张量成像(diffusion tensor imaging,DTI)测量一氧化碳中毒后迟发性脑病(delayed encephalopathy after acute carbon monoxide poisoning,DEACMP)患者脑结构网络改变,探讨DEACMP认知障碍的神经影像学机制。材料与方法分别对25例DEACMP患者和25例年龄、性别匹配的健康对照者(healthy controls,HCs)进行DTI扫描。应用自动解剖标签AAL模板将全脑共划分为90个区域。采用连续示踪法重建出脑纤维束连接网络和脑结构加权网络,并在构建出的两种不同网络基础上,用图论方法进行分析。采用两独立样本t检验比较DEACMP组和HCs组的网络特征参数。提取不同脑区的网络特征参数,分析DEACMP组与认知功能障碍的相关性。结果两组被试均显示出"小世界"属性。DEACMP组的最短路径长度增加(Lp=0.86±0.05),全局效率(Eglob=9.60±2.65)和局部效率(Eloc=17.98±3.89)下降。而且,DEACMP组的默认网络、突显网络、中央执行网络及视觉区域的核心节点减少(P<0.05,FDR校正)。DEACMP组左侧杏仁核节点度值与简易智力状态检查量表(simple intelligence status check scale,MMSE)、蒙特利尔认知评估(montrealcognitiveassessment,MoCA)评分呈明显正相关(r=0.863,P=0.001;r=0.525,P=0.021);左侧舌回节点度值与MoCA评分呈正相关(r=0.406,P=0.019),与临床痴呆评定量表(clinical dementia rating scale,CDR)评分呈负相关(r=-0.563,P=0.016)。DEACMP组右侧背外侧额上回节点效率值与CDR评分呈负相关(r=-0.377,P=0.031)。结论 DEACMP患者网络拓扑属性及节点的差异变化可显示DEACMP患者相关大脑区域特别是脑高级功能损害的程度。
关键词(KeyWords): 一氧化碳中毒;迟发性脑病;扩散张量成像;脑网络;小世界属性
基金项目(Foundation): 2018江西省研究生创新专项资金项目(编号∶YC2018-S109);; 江西省卫生健康委员会科技计划(编号∶20191040);; 江西省卫生厅科技计划(编号:20181701)~~
作者(Author): 蒋雯茜;伍清宇;赵梓茹;王亮;周璐;李丹;何来昌;谭永明;
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