论文部分内容阅读
目的利用磁共振成像技术结合基于体素的形态学(voxel-based morphology,VBM)及静息态局部一致性(regional homogeneity,ReHo)的分析方法探索2型糖尿病(type 2 diabetes mellitus,T2DM)患者大脑神经结构的微观变化及神经活动协同性的改变。方法研究共纳入26例T2DM患者及24名健康自愿者对照,采集所有被试大脑结构像及静息态功能数据。计算全脑体素的灰质体积(gray matter volume,GMV)及ReHo值并进行组间统计分析,提取存在显著差异脑区的GMV/ReHo值与临床数据做相关分析。结果 VBM结果显示与正常对照组相比T2DM患者双侧纹状体、双侧丘脑、左侧岛叶及左侧小脑的部分区域灰质体积明显降低(P<0.05,FDR校正)。ReHo减低的脑区(P<0.05,FDR校正)主要位于双侧舌回/距状裂周围皮层、楔叶、左侧枕上回/枕中回。ReHo升高的脑区主要位于颞叶、双侧纹状体、两侧丘脑、右侧额中回。患者双侧丘脑、右侧纹状体灰质体积与糖化血红蛋白值呈负相关。结论 T2DM患者纹状体、丘脑等灰质核团存在广泛的结构萎缩,并且这种结构的缺损与长期的血糖控制密切相关。局部脑区神经功能紊乱可能是患者认知功能损伤的基础,纹状体、丘脑等灰质核团体积萎缩而功能活动一致性增强可能是糖尿病脑病中枢系统损伤的早期代偿性表现。
Objective To explore the clinical significance of magnetic resonance imaging (MRI) in patients with type 2 diabetes mellitus (T2DM) based on voxel-based morphology (VBM) and regional homogeneity (ReHo) Microscopic changes of brain nerve structure and changes of neuronal activity synergies. Methods A total of 26 patients with T2DM and 24 healthy volunteers were enrolled in this study. Data of brain structure and resting state of all subjects were collected. The gray matter volume (GMV) and ReHo values of whole brain voxels were calculated and statistically analyzed between groups. The GMV / ReHo values of significant brain regions were extracted and correlated with clinical data. Results The results of VBM showed that compared with the normal control group, the volume of gray matter in the bilateral striatum, bilateral thalamus, left island and left cerebellum of T2DM patients decreased significantly (P <0.05, FDR correction). ReHo decreased brain areas (P <0.05, FDR correction) mainly located in the bilateral lingual gyral / division fissure around the cortex, the wedge leaves, the left occipital gyrus / middle occipital gyrus. ReHo elevated brain regions mainly located in the temporal lobe, bilateral striatum, both thalamus, right frontal gyrus. Patients with bilateral thalamus, right striatum gray matter volume and glycated hemoglobin value was negatively correlated. Conclusion There is extensive structural atrophy of gray matter nuclei such as striatum and thalamus in T2DM patients, and the defect of this kind of structure is closely related to long-term blood sugar control. Neurological disorders in the local brain areas may be the basis of cognitive impairment in patients with striatum and thalamus and other gray matter volume shrinking and enhanced functional activity may be central nervous system damage in diabetic encephalopathy early compensatory performance.