基于低频振幅方法的连枷臂综合征患者静息态功能磁共振成像研究
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摘要
目的 采用静息态功能磁共振成像(RS-fMRI)低频振幅(ALFF)分析法,探讨连枷臂综合征(Flail arm syndrome,FAS)患者基线脑活动变化及意义。方法 对10名确诊的连枷臂综合征患者(连枷臂组)和10名与之年龄、性别、教育程度相匹配的正常成年人对照者(对照组)进行静息态磁共振成像扫描,应用ALFF分析法计算并比较两组受试者全脑的ALFF值的差异,并进一步分析其与临床症状严重程度的相关性。结果 静息态下,与正常对照组相比较,FAS组在双侧楔前叶、左侧楔叶、后扣带回、枕上回、颞中回、枕中回、角回、顶下缘角回脑区均出现ALFF值的低于正常对照组,但没有发现FAS组ALFF增高的脑区。ALFF明显减低的脑区的ALFF值与ALS功能分级量(ALSFRS-R)总分无相关性。结论 静息态下主要在双侧楔前叶、左侧楔叶、后扣带回、枕上回、颞中回、枕中回、角回、顶下缘角回脑区的脑功能活动异常,这些脑区ALFF改变可能与FAS的病理机制有关,但与FAS疾病严重程度无关。
Objective The low-frequency amplitude( ALFF) analysis of resting-state functional magnetic resonance imaging( RS-fMRI) was used to investigate the changes and clinical significance of baseline brain activity in patients with flail arm syndrome( FAS). Methods Ten patients with flail-arm syndrome( FAS group) and ten normal adults( control group) matching with age,gender and education level were scaned with f MRI. ALFF analysis was used to calculate and compare the difference in ALFF values of the whole brain between the two groups and further analyze its correlation with the severity of clinical symptoms. Results In the resting state,the ALFF value of FAS group was lower than the normal control group at bilateral anterior wedge,left wedge,posterior cingulate gyrus,supra-pulmonary gyrus,middle iliac crest,middle occipital gyrus,angular gyrus,and inferior rim. There was no significant correlation between the ALFF value and the total score of ALS functional grading( ALSFRS-R) at the brain region with significantly reduced ALFF. Conclusion In the resting state,the brain function is abnormal in the bilateral anterior wedge,the left wedge,the posterior cingulate gyrus,the suprapulmonary gyrus,the middle iliac crest,the middle occipital gyrus,the angular gyrus,and the lower marginal horn. Regional ALFF changes may be related to the pathological mechanism of FAS,but not related to the clinical severity of FAS.
Objective The low-frequency amplitude( ALFF) analysis of resting-state functional magnetic resonance imaging( RS-fMRI) was used to investigate the changes and clinical significance of baseline brain activity in patients with flail arm syndrome( FAS). Methods Ten patients with flail-arm syndrome( FAS group) and ten normal adults( control group) matching with age,gender and education level were scaned with f MRI. ALFF analysis was used to calculate and compare the difference in ALFF values of the whole brain between the two groups and further analyze its correlation with the severity of clinical symptoms. Results In the resting state,the ALFF value of FAS group was lower than the normal control group at bilateral anterior wedge,left wedge,posterior cingulate gyrus,supra-pulmonary gyrus,middle iliac crest,middle occipital gyrus,angular gyrus,and inferior rim. There was no significant correlation between the ALFF value and the total score of ALS functional grading( ALSFRS-R) at the brain region with significantly reduced ALFF. Conclusion In the resting state,the brain function is abnormal in the bilateral anterior wedge,the left wedge,the posterior cingulate gyrus,the suprapulmonary gyrus,the middle iliac crest,the middle occipital gyrus,the angular gyrus,and the lower marginal horn. Regional ALFF changes may be related to the pathological mechanism of FAS,but not related to the clinical severity of FAS.
引文
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[18]Ouchi Y,Kikuchi M.A review of the default mode network in aging and dementia based on molecular imaging[J].Rev Neurosci,2012,23(3):263-268.
[2]Mathis S,Couratier P,Julian A,et al.Current view and perspectives in amyotrophic lateral sclerosis[J].Neural Regen Res,2017,12(2):181-184.
[3]Gordon PH.Amyotrophic lateral sclerosis:An update for 2013 clinical features,pathophysiology,management and therapeutic trials[J].Aging Dis,2013,4(5):295-310.
[4]Logroscino G,Traynor BJ,Hardiman O,et al.Descriptive epidemiology of amyotrophic lateral sclerosis:new evidence and unsolved issues[J].J Neurol Neurosurg Psychiatry,2008,79(1):6-11.
[5]Sasaki S,Iwata M.Atypical form of amyotrophic lateral sclerosis[J].JNeurol Neurosurg Psychiatry,1999,66(5):581-585.
[6]Vucic S,Ziemann U,Eisen A,et al.Transcranial magnetic stimulation and amyotrophic lateral sclerosis:pathophysiological insights[J].JNeurol Neurosurg Psychiatry,2013,84(10):1161-1170.
[7]Yang H,Liu M,Li X,et al.Neurophysiological differences between flail arm syndrome and amyotrophic lateral sclerosis[J].PLo S One,2015,10(6):e0127601.
[8]Yoon BN,Choi SH,Rha JH,et al.Comparison between flail arm syndrome and upper limb onset amyotrophic lateral sclerosis:Clinical features and electromyographic findings[J].Exp Neurobiol,2014,23(3):253-257.
[9]Xu YS,Fan DS.Clinical and neuro electrophysiologic study of flail arm syndrome[J].Zhonghua Yi Xue Za Zhi,2013,93(1):23-25.
[10]Zang YF,He Y,Zhu CZ,et al.Altered baseline brain activity in children with ADHD revealed by resting-state functional MRI[J].Brain Dev,2007,29(2):83-91.
[11]Brooks BR,Miller RG,Swash M,et al.El escorial revisited:revised criteria for the diagnosis of amyotrophic lateral sclerosis[J].Amyotroph Lateral Scler Other Motor Neuron Disord,2000,1(5):293-299.
[12]Yan CG,Wang XD,Zuo XN,et al.DPABI:Data Processing&Analysis for(Resting-State)Brain Imaging[J].Neuroinformatics,2016,14(3):339-351.
[13]Luo C,Chen Q,Huang R,et al.Patterns of spontaneous brain activity in amyotrophic lateral sclerosis:a resting-state FMRI study[J].PLo S One,2012,7(9):e45470.
[14]Zhu W,Fu X,Cui F,et al.ALFF value in right parahippocampal gyrus acts as a potential marker monitoring amyotrophic lateral sclerosis progression:a neuropsychological,voxel-based morphometry,and resting-state functional MRI study[J].J Mol Neurosci,2015,57(1):106-113.
[15]Davey CG,Pujol J,Harrison BJ.Mapping the self in the brain’s default mode network[J].Neuroimage,2016,132:390-397.
[16]Shulman GL,Fiez JA,Corbetta M,et al.Common blood flow changes across visual tasks:II.decreases in cerebral cortex[J].J Cogn Neurosci,1997,9(5):648-663.
[17]Ding X,Li CY,Wang QS,et al.Patterns in default-mode network connectivity for determining outcomes in cognitive function in acute stroke patients[J].Neuroscience,2014,277:637-646.
[18]Ouchi Y,Kikuchi M.A review of the default mode network in aging and dementia based on molecular imaging[J].Rev Neurosci,2012,23(3):263-268.