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目的应用静息态功能磁共振成像(rs-fMRI)技术研究原发性闭角型青光眼(PACG)患者初级视觉皮层(PVC)功能连接的变化情况。方法选取临床确诊的PACG患者(PACG组)及与之年龄、性别相匹配的健康对照组(HC组)行3T磁共振T_1结构像及功能像扫描,最终纳入PACG组和HC组各25例进行rs-fMRI分析。磁共振数据经预处理后,以PVC中心区作为种子点,计算其与全脑体素时间序列的相关性并比较组间静息态功能连接的差异,并分析患者组显著差异脑区功能连接系数与临床变量的相关性。结果与HC组相比,PACG组左侧距状皮层(BA18)、左侧舌回(BA18)、右侧楔叶(BA18)、右侧后扣带回、右侧小脑前叶与PVC之间的功能连接减低,PVC功能连接增强的脑区包括左侧颞上回、右侧海马、右侧顶下小叶、双侧岛叶、双侧Extra-nuclear gyrus及双侧壳核(P﹤0.01,Alphasim校正)。PVC与左侧颞上回、右侧顶下小叶间增强的功能连接与视力(VA)呈正相关。结论PACG患者PVC区存在与高级视觉皮层和视觉外脑区功能连接下降,与视力相关的功能连接代偿性增强,提示PVC功能连接异常在PACG疾病进展中起重要作用。
Objective To investigate the changes of primary visual cortex (PVC) functional connectivity in patients with primary angle-closure glaucoma (PACG) by resting state functional magnetic resonance imaging (rs-fMRI). Methods PACG group and healthy control group (HC group), which were clinically diagnosed as PACG group, were scanned with 3T magnetic resonance T 1 scans and functional imaging scan, and finally 25 cases in PACG group and HC group rs-fMRI analysis. After the magnetic resonance data were preprocessed, the PVC central area was used as the seed point to calculate the correlation with the whole brain voxel time series and to compare the difference of resting state functional connectivity among the groups, and to analyze the significant differences in functional connectivity of brain regions Correlation between factors and clinical variables. Results Compared with HC group, there was no significant difference between PACG group on the left subcortical (BA18), left lingual (BA18), right wedge (BA18), right posterior cingulate gyrus, (P <0.01, P <0.01, P <0.01, P <0.01). The brain regions with enhanced PVC connectivity include the left superior temporal gyrus, the right inferior hippocampus, the right inferior parietal lobule, bilateral islets, bilateral Extra- Alphasim correction). PVC and the left superior temporal gyrus, right superior parietal lobule enhanced functional connectivity and visual acuity (VA) was positively correlated. Conclusions There is a decrease in functional connectivity with visual cortex and visual extracranial area in PVP patients and a compensatory increase in visual acuity-related functional connectivity, suggesting that abnormal PVC function plays an important role in the progression of PACG.