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周治明,赵建农,郭大静,张维,吴伟,张波莉,吴媛,王晚千,周红俐.轻微型肝性脑病神经元自发活动异常功能磁共振研究[J].陆军军医大学学报(原第三军医大学学报),2013,35(24 ):2697-2704. Zhou Zhiming,Zhao Jiannong,Guo Dajing,Zhang Wei,Wu Wei,Zhang Boli,Wu Yuan,Wang Wanqian,Zhou Hongli.Abnormality of spontaneous neuronal activity in minimal hepatic encephalopathy: a resting-state functional MRI study[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(24 ):2697-2704.
周治明, 赵建农, 郭大静, et al. Abnormality of spontaneous neuronal activity in minimal hepatic encephalopathy: a resting-state functional MRI study[J]. Journal of Army Medical University, 2013, 35(24): 2697-2704.
周治明,赵建农,郭大静,张维,吴伟,张波莉,吴媛,王晚千,周红俐.轻微型肝性脑病神经元自发活动异常功能磁共振研究[J].陆军军医大学学报(原第三军医大学学报),2013,35(24 ):2697-2704. Zhou Zhiming,Zhao Jiannong,Guo Dajing,Zhang Wei,Wu Wei,Zhang Boli,Wu Yuan,Wang Wanqian,Zhou Hongli.Abnormality of spontaneous neuronal activity in minimal hepatic encephalopathy: a resting-state functional MRI study[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(24 ):2697-2704. DOI:
周治明, 赵建农, 郭大静, et al. Abnormality of spontaneous neuronal activity in minimal hepatic encephalopathy: a resting-state functional MRI study[J]. Journal of Army Medical University, 2013, 35(24): 2697-2704. DOI:
目的 采用静息状态下血氧水平依赖功能磁共振(BOLD-fMRI)技术和低频振幅(ALFF)及比率低频振幅(fALFF)方法评价轻微型肝性脑病(MHE)患者神经元自发活动改变情况。 方法 搜集14例MHE患者(MHE组)和 14例健康对照者(HC组)行神经心理测试及静息状态下BOLD-fMRI扫描,利用DPARSF软件预处理图像数据并获取ALFF和fALFF进行统计分析。 结果 与HC组相比,静息态下MHE患者表现为额叶分布为主的全脑多个脑区ALFF及fALFF异常,包括在右颞下回、右颞极/颞中回、左岛叶、右小脑半球后叶等脑区ALFF升高,在双侧额叶多个脑区、双侧楔前叶、右小脑半球后叶等脑区ALFF降低(
P
0.05);以及在左侧额叶多个脑区、右中扣带回/额中下回、右楔前叶/后扣带回、右岛叶、右豆状核、左苍白球、脑桥/左小脑半球前叶等脑区fALFF升高,在双侧额前内侧回、右额中回、右颞上回、左小脑半球后叶等脑区fALFF降低(
P
0.05)。进一步相关分析发现右楔前叶、左额前内侧回ALFF既与NCT-A评分呈显著负相关(r
右楔前叶
=-0.764 1
r
左额前内侧回
=-0.761 8),亦与DST评分呈显著正相关(r
右楔前叶
=0.868 6
r
左额前内侧回
=0.723 4,
P
0.05)。 结论 MHE患者静息态下全脑多个脑区ALFF及fALFF存在异常,尤其是右楔前叶和左额前内侧回异常,可能对MHE检测具有更重要的价值,而联合ALFF及fALFF方法能够更加全面地评价MHE脑神经元活动异常。
Objective To explore the abnormality of spontaneous neuronal activity at the baseline in minimal hepatic encephalopathy (MHE) patients with resting-state blood oxygen level dependent-functional MRI (BOLD-fMRI) as well as amplitude of low-frequency fluctuation (ALFF) and fraction ALFF (fALFF) analysis. Methods
Fourteen patients with MHE (MHE group) defined by neuropsychological tests and 14 sex-
age-
and education-matched healthy controls (HC group) attended the neuropsychological tests and BOLD-fMRI scanning. MR image preprocessing was preformed with data processing assistant for resting-state fMRI (DPARSF) software package. ALFF and fALFF were used for statistical analysis. Results Compared with the HC group
many regions of the whole brain in the MHE group showed abnormal ALFF or fALFF values
which were mainly located in the front lobes. In the MHE group
the higher ALFF brain regions included right inferior temporal gyrus (ITG)
right temporal pole/middle temporal gyrus
left insular and the posterior lobe of right cerebellum; and the lower brain regions included some regions of bilateral front lobes
bilateral precuneus and the posterior lobe of right cerebellum (
P
0.05). The higher fALFF regions included several regions of left front lobe
right middle cingulum gyrus/middle and inferior frontal gyrus (MCC-M/IFG)
right precuneus/posterior cingulate cortex
right insula
right lentiform nucleus
left pallidum and pons/the anterior lobe of left cerebellum; and the lower fALFF regions included bilateral medial prefrontal cortex (MPFC)
right middle frontal gyrus (MFG)
right superior temporal gyrus (STG) and the posterior lobe of left cerebellum (
P
0.05). Moreover
the ALFF in the right precuneus and left MPFC of MHE patients showed significant negative correlation with the NCT-A score (r
precuneus
=-0.764 1
r
MPFC
=-0.761 8) and significant positive correlation with the DST score (r
precuneus
=0.868 6
r
MPFC
=0.723 4
P
0.05). Conclusion MHE patients show abnormal ALFF and fALFF in many regions of the brain under resting state
especially the right precuneus and left MPFC
which may be of great importance to MHE diagnosis. It could be more comprehensive to evaluate the abnormal neuronal activity in MHE patients with the combination of
ALFF and fALFF patterns.
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