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ENGLISH ABSTRACT
分数低频振幅技术对非增生性糖尿病视网膜病变患者静息态脑功能改变的评估
齐沉星
黄歆
童妍
沈吟
作者及单位信息
·
DOI： 10.3760/cma.j.cn115989-20190920-00406
Changes of brain function in resting-state in patients with nonproliferative diabetic retinopathy assessed by fractional low-frequency amplitude technique
Qi Chenxing
Huang Xin
Tong Yan
Shen Yin
Authors Info & Affiliations
Qi Chenxing
Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China
Huang Xin
Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China
Tong Yan
Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China
Shen Yin
Eye Center, Renmin Hospital of Wuhan University, Wuhan 430060, China
·
DOI： 10.3760/cma.j.cn115989-20190920-00406
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摘要

目的利用静息态功能磁共振成像(rs-fMRI)的分数低频振幅(fALFF)技术研究糖尿病视网膜病变(DR)患者的静息态脑功能改变。

方法采用横断面研究方法，收集2018年7月至2019年3月于武汉大学人民医院就诊的34例非增生性DR患者为DR组，同期于当地社区招募34名年龄、性别、受教育程度相匹配的健康志愿者为正常对照组。所有受检者均接受常规MRI和rs-fMRI检查，计算全脑fALFF值，比较2个组受检者不同脑区fALFF测定值。

结果DR组患者左侧颞叶下回、左侧小脑区、右侧苍白球、左侧辅助运动区和右侧眶额叶上回fALFF值分别为-0.58±0.29、-0.47±0.39、-0.37±0.24、-0.31±0.26和0.29±0.49，均明显高于正常对照组的-1.03±0.29、-0.90±0.31、-0.78±0.22、-0.72±0.21和-0.17±0.46，差异均有统计学意义(体素水平 P<0.01，高斯随机场校正，聚类水平 P<0.05)(均 P<0.001)。

结论DR患者存在多个脑区的神经元活动异常，包括左侧颞叶下回、左侧小脑区、右侧苍白球、左侧辅助运动区和右侧眶额叶上回。这些异常神经元活动区域可能与认知、视觉、情绪等方面的功能有关。

糖尿病视网膜病变;静息态功能磁共振成像;分数低频振幅
ABSTRACT

ObjectiveTo study the changes of brain function in patients with diabetic retinopathy (DR) by using resting-state functional magnetic resonance imaging (rs-fMRI) based on the fractional amplitude of low-frequency fluctuation (fALFF) method.

MethodsA cross-sectional study method was performed, 34 cases of non-proliferative DR patients treated in the Renmin Hospital of Wuhan University during July 2018 to March 2019 were collected.Meanwhile, 34 healthy volunteers with matched age, gender, and education years were recruited.All subjects were performed with conventional MRI scanning and rs-fMRI scanning, then the fALFF values in the whole brain were calculated, and the differences of neuronal activities between the two groups were explored.This research protocol was approved by the Ethic Committee of Renmin Hospital of Wuhan University, and written informed consent was obtained from each subject before any medical examination.

ResultsThe fALFF values of DR patients in the left inferior temporal gyrus, left cerebellum, right pallidum, left supplementary motor area, and right superior orbitofrontal gyrus were -0.58±0.29, -0.47±0.39, -0.37±0.24, -0.31±0.26 and 0.29±0.49, respectively, which were significantly higher than -1.03±0.29, -0.90±0.31, -0.78±0.22, -0.72±0.21 and-0.17±0.46 of the normal control (voxel level P<0.01, gaussian random field correction, cluster level P<0.05)(all at P<0.001).

ConclusionsAbnormal spontaneous neuronal activities occur in the left inferior temporal gyrus, left cerebellum, right pallidum, left supplementary motor area, and right superior orbitofrontal gyrus of DR patients.These abnormalities may associate with cognitive, vision and emotion.

Diabetic retinopathy;Resting-state functional magnetic resonance imaging;Fractional amplitude of low-frequency fluctuation
Shen Yin, Email: nc.defudabe.uhwnehsniy
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引用本文

齐沉星,黄歆,童妍,等. 分数低频振幅技术对非增生性糖尿病视网膜病变患者静息态脑功能改变的评估[J]. 中华实验眼科杂志,2020,38(09)：760-765.

DOI:10.3760/cma.j.cn115989-20190920-00406

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糖尿病视网膜病变(diabetic retinopathy，DR)是糖尿病常见的眼部微血管并发症，也是全世界中老年人获得性视力丧失的主要原因之一。DR主要表现为视网膜微血管瘤、视网膜出血、黄斑水肿和视网膜新生血管等，病情严重者可出现视网膜脱离而导致视力明显下降 [ 1 ]。流行病学研究预测全世界DR患者在2030年将达到1.91亿 [ 2 ]。DR主要病理改变为毛细血管无灌注、血管渗漏及退行性改变，可导致增生性视网膜脱离和致盲。视网膜血管系统具有与脑血管相似的解剖学、生理学和胚胎学特征，因此，DR患者更容易出现大脑白质萎缩和灰质减少，长期DR患者出现腔隙性脑梗死和脑卒中的风险也会明显升高 [ 3 , 4 , 5 ]。大量神经影像学证据发现，DR患者表现出与认知功能相关的脑区结构异常，认知能力下降和发生痴呆的风险增加 [ 6 , 7 ]。然而国内外对于DR患者认知功能障碍的发病机制研究较少。核磁共振成像(magnetic resonance imaging，MRI)技术具有无创、安全、多方位、多角度等成像特点，近年来其被越来越多地应用于临床疾病的诊断和疗效的评估 [ 8 , 9 ]。其中，分数低频振幅(fractional amplitude of low-frequency fluctuation，fALFF)技术通过测量大脑血流低频振荡幅度来检测自发神经元活动，具有较高的敏感性和特异性，现已成熟应用于中枢神经系统疾病的研究 [ 10 , 11 ]。本研究采用静息态功能磁共振成像(resting-state functional magnetic resonance imaging，rs-fMRI)的fALFF分析方法，观察DR患者静息态脑部神经元活动的变化，旨在进一步探讨DR患者认知功能障碍的发生机制。
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备注信息
A
沈吟，Email： nc.defudabe.uhwnehsniy
B
所有作者均声明不存在任何利益冲突
C
国家重点研发计划"政府间国际科技创新合作/港澳台科技创新合作"重点专项项目 (2017YFE0103400)
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