类风湿关节炎患者皮层形态改变与认知损害的相关性分析

王尧; 左智炜; 石颖; 邹庆华; 方勇飞; 黎海涛

doi:10.16016/j.1000-5404.201710029

您当前的位置：

首页 >

文章列表页 >

类风湿关节炎患者皮层形态改变与认知损害的相关性分析

临床医学 | 更新时间：2026-01-09

- 类风湿关节炎患者皮层形态改变与认知损害的相关性分析
- Correlation of cortical abnormality with cognitive impairment in patients with rheumatoid arthritis
- 第三军医大学学报 2018年40卷第5期页码：426-430
- 作者机构：
  
  1.400038 重庆，陆军军医大学(第三军医大学)第一附属医院放射科
  2.400038 重庆，陆军军医大学(第三军医大学)第一附属医院中西医结合科
- 作者简介：
  
  [黎海涛，E-mail：13883818704@163.comLI Haitao, E-mail: 13883818704@163.com
- 基金信息：
  
  国家自然科学基金面上项目(81373180)
- DOI：10.16016/j.1000-5404.201710029
  中图分类号： R322.81;R445.2;R593.22
- 收稿：2017-10-10，
  
  修回：2017-12-12，
  
  纸质出版：2018-03-15
- 稿件说明：
移动端阅览
王尧, 左智炜, 石颖, 等. 类风湿关节炎患者皮层形态改变与认知损害的相关性分析[J]. 第三军医大学学报, 2018,40(5):426-430.

Yao WANG, Zhiwei ZUO, Ying SHI, et al. Correlation of cortical abnormality with cognitive impairment in patients with rheumatoid arthritis[J]. Journal of Third Military Medical University, 2018, 40(5): 426-430.
王尧, 左智炜, 石颖, 等. 类风湿关节炎患者皮层形态改变与认知损害的相关性分析[J]. 第三军医大学学报, 2018,40(5):426-430. DOI： 10.16016/j.1000-5404.201710029.

Yao WANG, Zhiwei ZUO, Ying SHI, et al. Correlation of cortical abnormality with cognitive impairment in patients with rheumatoid arthritis[J]. Journal of Third Military Medical University, 2018, 40(5): 426-430. DOI： 10.16016/j.1000-5404.201710029.

摘要

目的

观测类风湿关节炎(rheumatoid arthritis，RA)患者大脑皮层厚度及表面积的改变，探讨其与认知功能损害的关系。

方法

收集2016年12月至2017年5月在本院中西医结合科确诊的50例RA患者(RA组)及同期40例性别、年龄、受教育程度相匹配的健康志愿者(对照组)行高分辨率3D-T

WI结构相扫描，利用Freesurfer软件分析两组间皮层厚度及表面积的差异，与患者的认知功能评分进行相关及回归分析。

结果

磁共振图像处理结果显示，与对照组比较，RA组的左侧额下回岛盖、额上回、额中回下部，右侧中央前回、海马旁回、皮层厚度明显的减低(

0.05)；右侧中央后回皮层表面积明显减低(

0.05)。RA组MoCA及MMSE总分，视空间执行功能、注意、语言、延迟回忆、定向功能得分较对照组明显降低(

0.05)；控制年龄、受教育程度、病程后，经多元逐步回归，RA患者海马旁回皮层厚度与延迟回忆、定向功能评分，右侧中央前回皮层厚度与MoCA总分及语言、视空间执行功能等评分均呈正相关(

0.05)。

结论

RA患者多个脑区的皮层厚度变薄，表面积减少，认知功能存在受损，部分皮层厚度的改变与RA患者认知功能损害有关。

Abstract

Objective

To investigate the changes of cortical thickness and cortical surface area in rheumatoid arthritis (RA) patients

and explore the relationship of these changes with cognitive impairment.

Methods

A total of 50 RA patients admitted in the Department of Integrated Chinese and Western Medicine of our hospital from October 2016 to May 2017 were enrolled in this study. Another 40 healthy volunteers matched with sex

age and educational level served as control. All subjects underwent 3D-T

WI scanning. The original 3D-T

WI brain images were analyzed with Freesurfer software

and the values of cortical thickness and surface area were extracted for the difference between the 2 groups. Correlation and regression analyses were used to determine the factors that affect the changes of cortical abnormalities with cognitive scores.

Results

The analysis on 3D-T

WI images showed that compared to the control group

the RA group had significantly decreased cortical thickness in left pars opercularis of inferior frontal gyrus

left superior frontal gyrus

left rostral middle frontal gyrus

right precentral gyrus

and right para-hippocampal gyrus (

0.05)

and obviously declined cortical surface area in postcentral gyrus (

0.05). The total scores of MoCA and MMSE

visuospatial/executive

attention

language

delayed recall and orientation were significant reduced in the RA group than the control (

0.05). After adjustmen

t for age

educational level

course of disease

stepwise regression analysis indicated that right para-hippocampal cortical thickness were positively correlated with delayed recall score

right precentral cortex thickness and total scores of MoCA

language and visuospatial/executive function (

0.05).

Conclusion

The RA patients have significantly decreases in cortical thickness and surface areas

and are accompanied by cognitive impairment. The changes of some cortex thickness are obviously associated with cognitive impairment.

关键词

Keywords

references

JEFFERY R C. Clinical features of rheumatoid arthritis[J]. Medicine, 2010, 38(4):167-171. DOI: 10.1016/j.mpmed.2009.12.004.

Ungprasert P, Wijarnpreecha K, Thongprayoon C. Rheumatoid arthritis and the risk of dementia: A systematic review and meta-analysis[J]. Neurol India, 2016, 64(1): 56-61.DOI: 10.4103/0028-3886.173623.

JULIAN L J, YAZDANY J, TRUPIN L, et al . Validity of brief screening tools for cognitive impairment in rheumatoid arthritis and systemic lupus erythematosus[J ] . Arthritis CareRes, 2012, 64(3):448-454. DOI: 10.1002/acr.21566.

ALETAHA D, NEOGI T, SILMAN A J, et al . 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative[J ] . Arthritis Rheum, 2010. 62(9): 2569-2581.DOI: 10.1002/art.27584.

FISCHL B.FreeSurfer[J]. Neuro Image, 2012, 62(2): 774-781. DOI: 10.1016/j.neuroimage.2012.01.021.

BIZZO B C, SANCHEZ T A, TUKAMOTO G, et al . Cortical thickness and episodic memory impairment in systemic lupus erythematosus[J ] . J Neuroimaging, 2017, 27(1):122-127.DOI:10.1111/jon.12394.

ZHAO L, TAN X, WANG J, et al . B rain white matter structural networks in patients with non-neuropsychiatric systemic lupus erythematosus[J ] . Brain Imaging Behav, 2017.. DOI: 10.1007/s11682-017-9681-3.

WARTOLOWSKA K, HOUGH MG, JENKINSON M, et al . Structural changes of the brain in rheumatoid arthritis[J ] . Arthritis Rheum, 2012, 64(2): 371-379. DOI: 10.1002/art.33326.

BARTOLINI M, CANDELA M, BRUGNI M, et al . Are behaviour and motor performances of rheumatoid arthritis patients influenced by subclinical cognitive impairments? A clinical and neuroimaging study[J ] . Clin Exp Rheumatol, 2002, 20(4):491-497.

MAKRIS N, BIEDERMAN J, VALERA EM, et al .Cortical thinning of the attention and executive function networks in adults with attention-deficit/hyperactivity disorder[J ] . Cereb Cortex, 2007, 17(6):1364-1375. DOI: 10.1093/cercor/bhl047.

FUNAHASHI S, ANDREAU J M. Prefrontal cortex and neural mechanisms of executive function[J].J Physiol Paris, 2013, 107(6): 471-482. DOI: 10.1016/j.jphysparis.2013.05.001.

BALCONI M. Dorsolateral prefrontal cortex, working memory and episodic memory processes: insight through transcranial magnetic stim-ulationtechniques[J]. Neurosci Bull, 2013, 29(3): 381-389. DOI: 10.1007/s12264-013-1309-z.

MILLER E K, COHEN J D. An integrative theory of prefrontal cortex function[J]. Ann Rev Neurosci, 2001, 24(1): 167-202. DOI: 10.1146/annurev.neuro.24.1.167.

KOENIGS M, GRAFMAN J. The functional neuroanatomy of depression: distinct roles for ventromedial and dorsolateral prefrontal cortex[J]. Behav Brain Res, 2009, 201(2): 239-243. DOI: 10.1016/j.bbr.2009.03.004.

APKARIAN A V, SOSA Y, SONTY S, et al . Chronic back pain is associated with decreased prefrontal and thalamic gray matter density[J ] . J Neurosci, 2004, 24(46): 10410-10415. DOI: 10.1523/JNEUROSCI.2541-04.2004.

PAMUK O N, KISACIK B, PAMUK G E, et al . Do impaired memory, cognitive dysfunction and distress play a role in methotrexate-related neutropenia in rheumatoid arthritis patients? A comparative study[J ] . Rheumatol Int, 2013, 33(10):2631-2635. DOI: 10.1007/s00296-013-2792-2.

BARKER G R, BANKS P J, SCOTT H, et al . Separate elements of episodic memory subserved by distinct hippocampal-prefront al connections[J ] . Nat Neurosci, 2017, 20(2):242-250. DOI:10.1038/nn.4472.

AFSHARI N A, AFSHARI M A, FOSTER C S. Inflammatory conditions of the eye associated with rheumatic diseases[J]. Curr Rheumatol Rep, 2001, 3(5): 453-458. DOI: 10.1007/s11926-996-0017-3.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

基于磁共振DSC-PWI构建的肿瘤血管生境对胶质母细胞瘤和单发脑转移瘤鉴别诊断效能的研究

T1rho磁共振技术定量评估腰痛患者椎间盘早期退行性改变

2.65 GHz射频长期辐射对小鼠机体炎症反应和肠道微生态的影响

DCE-MRI参数评估喉癌术后放疗短期预后的研究

基于MRI增强的体素减影技术对复发胶质母细胞瘤患者预后评估的价值