南方医科大学学报

南方医科大学学报 ›› 2018, Vol. 38 ›› Issue (12): 1433-.doi: 10.12122/j.issn.1673-4254.2018.12.06

• • 上一篇    下一篇

静息态功能磁共振评估2型糖尿病周围神经病变患者的脑功能

邱丽君，谭相良，邹梦晨，劳斌昌，许乙凯，薛耀明，高方，曹瑛   

  • 出版日期:2018-12-20 发布日期:2018-12-20

Changes in regional homogeneity of brain activity in patients with diabetic peripheral neuropathy: a study with resting-state functional magnetic resonance imaging

  • Online:2018-12-20 Published:2018-12-20

HTML

PDF

1633

摘要： 目的采用静息态功能磁共振成像（rs-fMRI）技术，观察2型糖尿病周围神经病变（DPN）患者局部脑区神经元活动的局部 一致性（ReHo）与糖尿病无神经病变患者的差异，分析脑功能活动改变与DPN的关系。方法纳入36例DPN患者，分为痛性糖 尿病神经病变组（Painful DPN组）20 例，非痛性糖尿病神经病变组（Painless DPN组）16 例，对照组为16 例糖尿病无神经病变 （Non-DPN组）患者。对所有受试者进行一般临床指标检查、认知与情绪量表评估及脑部rs-fMRI扫描。应用数据处理软件对 扫描图像进行分析，计算各组ReHo并进行组间比较。结果三组间比较，年龄、性别、受教育年限、糖尿病病程、蒙特利尔认知评 估无显著统计学差异（P>0.05）。与Non-DPN组相比，Painful DPN组及Painless DPN组焦虑及抑郁自评量表、睡眠自评量表评 分均显著升高（P<0.05）。与Non-DPN组相比，Painful DPN组左侧颞下回、右侧中央后回ReHo升高，后扣带回、右侧顶下回、左 侧顶上回ReHo降低（P<0.05）。与Non-DPN组相比，Painless DPN组左侧颞下回、右侧颞中回、右侧额上回ReHo升高，左侧丘 脑ReHo降低（P<0.05）。Painful DPN组与Painless DPN组间ReHo无显著统计学差异（P>0.05）。结论DPN患者存在多个脑区 及默认网络区域神经元活动的局部一致性改变，左侧颞下回可能是其功能代偿脑区。Painful DPN患者的疼痛症状可能与右侧 中央后回神经元活动异常相关。

Abstract: Objective To investigate the abnormalities in regional homogeneity of brain activity in patients with diabetic peripheral neuropathy (DPN) using resting-state functional magnetic resonance imaging (rs-fMRI) and explore the association between brain activity changes and DPN. Methods A regional homogeneity (ReHo) approach was used to compare the local synchronization of rs-fMRI signals among 20 patients with painful DPN, 16 patients with painless DPN, and 16 type 2 diabetic patients without DPN (non-DPN group). Results Compared with the those without DPN, the patients with painful DPN showed high ReHo in the left inferior temporal gyrus and the right central posterior gyrus, and low ReHo in the posterior cingulate gyrus, right inferior parietal gyrus, and the left superior parietal gyrus (P<0.05); the patients with painless DPN group showed high ReHo in the left inferior temporal gyrus, the right middle temporal gyrus, and the right superior frontal gyrus, and low ReHo in the left thalamus (P<0.05). No significant differences in ReHo were found between the patients with painful DPN and painless DPN (P>0.05). Conclusion The patients with DPN have altered ReHo in multiple brain regions and impairment of a default mode network, for which the left temporal gyrus may serve as a functional compensatory brain area. ReHo disturbance in the central right posterior gyrus may play a central role in the pain symptoms associated with painful DPN.