| 文曼,王艳昕,朱龙,等.肝豆状核变性伴轻度认知障碍病人的静息态功能磁共振成像研究[J].安徽医药,2025,29(1):123-128. |
| 肝豆状核变性伴轻度认知障碍病人的静息态功能磁共振成像研究 |
| Resting-state functional magnetic resonance imaging study in patients with Wilson disease with mild cognitive impairment |
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| DOI：10.3969/j.issn.1009-6469.2025.01.025 |
| 中文关键词: 肝豆状核变性 轻度认知障碍 功能磁共振 低频振幅 功能连接 |
| 英文关键词: Hepatolenticular Degeneration Mild cognitive impairment Functional magnetic resonance Amplitude of low fre-quency fluctuation Functional connectivity |
| 基金项目:安徽高校自然科学研究项目( KJ2020A0438)；第四批全国优秀临床人才项目(国中医人教发〔 2017〕24号) |
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| 中文摘要: |
| 目的探讨静息态功能磁共振成像( rrs-fMRI)技术及神经心理学方法对肝豆状核变性［又称 Wilson病( WD)］伴轻度认知障碍( MCI)病人脑网络与功能差异研究的价值。方法 2023年 3—11月于安徽中医药大学第一附属医院招募符合中华医学会肝病学分会遗传代谢性肝病协作组编写的 WD诊断标准病人，根据蒙特利尔认知评估量表( MoCA)评分、简易精神状态量表( MMSE)评分、日常生活能力量表( ADL)评分将病人分为 WD-MCI组 17例和 WD不伴轻度认知障碍( WD-nMCI)组 10例，采集所有受试者 rrs-fMRI及成套认知功能评估量表数据，使用 DPARSF软件对磁共振数据进行预处理和差异脑区的构建，并采用 MATLAB软件平台以二阶分析、参数估计和结果比较的步骤对低频振幅( ALFF)与功能连接( FC)值进行校正，随后将差异脑区与量表评分进行统计学分析。结果对比 WD-nMCI组， WD-MCI组在数字广度、顺行和逆行记忆、注意力、额叶功能等方面的量表评分分别为 13.0(12.0，13.5)分、 19.0(13.0，20.5)分、 14.0(13.0，16.0)分、 18.0(16.0，19.0)分， WD-nMCI组分别为 14.0(14.0，15.0)分、 31.0(30.8，32.0)分、 17.5(17.0，18.0)分、 19.0(19.0，20.0)分，差异有统计学意义(P<0.05)； WD-MCI组的左侧海马旁回 ALFF值升高；而左侧补充运动区、右侧补充运动区和左侧中央前回 ALFF降低。将种子点设为双侧海马旁回时， WD-MCI组的左侧舌回、右侧舌回和左侧距状裂周围皮层、右侧颞上回和右侧颞横回功能连接值减低。结论 WD-MCI病人和 WD-nMCI病人在认知域损害的差异与 ALFF值变化的脑区有关；根据脑网络的连接强度结果，可说明 WD-MCI病人的认知损害可能与默认模式网络、视听觉网络之间的紧密性减低有关。 |
| 英文摘要: |
| Objective To explore the effects of resting state functional MRI (rs-fMRI) and neuropsychological methods on Wilson dis.ease(WD) and the value of studying brain network and function differences in patients with mild cognitive impairment (MCI). Methods From March 2023 to November 2023, the First Affiliated Hospital of Anhui University of Chinese Medicine recruited patients meetingthe diagnostic criteria for WD compiled by the Genetic Metabolic Liver Disease Collaboration Group of the Hepatology Branch of theChinese Medical Association. The patients were divided into WD-MCI group and WD group without mild cognitive impairment (WD-nMCI) group according to the scores of the Montreal Cognitive Assessment Scale (MoCA), the Minimum Mental State Examination Scale(MMSE) and the activity of daily living (ADL) scale. The resting FMRI images and the complete set of cognitive function assessmentscale data of all subjects were collected. DPARSF software was used to preprocess the magnetic resonance data and construct the differ-ential brain region, and MATLAB software platform was used to correct the amplitude of low frequency fluctuation (ALFF) and function-al connectivity (FC) values through the steps of second-order analysis, parameter estimation and result comparison. Then the differen-tial brain region and scale score were statistically analyzed.Results In comparison to the WD-nMCI group, the scale scores of the WD-MCI group in the areas of numerical breadth, prospective and retrograde memory, attention, frontal lobe functioning were 13.0 (12.0,13.5) score, 19.0 (13.0, 20.5)score, 14.0 (13.0, 16.0) score, 18.0(16.0, 19.0) score, and in the WD-nMCI group 14.0(14.0, 15.0) score,31.0 (30.8, 32.0) score, 17.5 (17.0, 18.0) score, 19.0 (19.0, 20.0) score. The difference was statistically significant (P<0.05). The ALFF value of the left parahippocampal gyrus increased in WD-MCI group. ALFF decreased in the left supplementary motor area, the rightsupplementary motor area and the left anterior central gyrus. When the seed point was set as bilateral parahippocampal gyrus, the func-tional connection values of left lingual gyrus, right lingual gyrus and left pericalar cleft cortex, right superior temporal gyrus and righttransverse temporal gyrus decreased in WD-MCI group.Conclusions This study reveals that the difference in cognitive domain dam-age between WD-MCI patients and WD-nMCI patients is related to the brain region with the change of ALFF value. According to the re-sults of the connection strength of brain network, it can be suggested that the cognitive impairment of WD-MCI patients may be related to the reduced tightness between the default mode network and the visual and auditory network. |
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