【摘要】 目的应用静息态功能磁共振计算度中心性指标分析急性甲亢肌病(acute thyrotoxic myopathy,ATM)患者脑功能变化与临床表现关联性及其可能机制。方法选取2018年1月至2019年6月在广西医科大学第一附属医院内分泌科初诊且未行治疗的16例ATM患者,同时期招募16例健康人(年龄、性别相匹配)为正常对照组。评估受试者临床症状并采集静息态功能磁共振图像,计算全脑度中心性(degree centrality,DC)值,检测ATM组与正常对照组DC值存在差异的脑区,并与临床症状做相关分析。结果 ATM组左侧补充运动区及背外侧额上回DC值低于正常对照组(P <0.001,FWE校正),且DC值与首次发病年龄呈正相关(r=0.514,P=0.041),且与血清TGAb值呈负相关(r=-0.532,P=0.034)。用于评价临床症状的急性甲亢肌病评分法(ATMSE)与血清FT3、FT4值呈正相关(r=0.603,P=0.013;r=0.590,P=0.016)。结论 ATM患者左侧补充运动区及背外侧额上回存在异常功能性变化,局部脑区异常活动可能导致ATM出现相应临床症状。更多还原

【Abstract】 Objective The aim of this study is to investigate the changes of resting brain function inpatients who suffered from acute thyrotoxic myopathy(ATM)with degree centrality(DC)and assessed by resting-state functional MRI.Methods16 patients with ATM who were newly diagnosed and untreated were recruited atthe Endocrinology Department of the First Affiliated Hospital of Guangxi Medical University from January 2018 toJune 2019. At the same time,16 healthy individuals who had matched sex and age were served as control. Partici-pants were assessed for clinical symptoms and received resting-state functional magnetic resonance imaging scanswhich calculated the total brain DC values. The differences in brain region between ATM groups and healthy con-trols were detected. The correlation analysis was applied using the clinical manifestations.ResultsThe DC valuesin the left supplementary motor area and the dorsolateral part of the Superior frontal gyrus in ATM groups were lowerthan healthy controls(P < 0.001,FWE correction). The brain regional DC values were positively correlated withthe age of first onset(r = 0.514,P = 0.041),while negatively correlated with the serum anti-thyroglobulin antibodies(TGAb)values(r =-0.532,P = 0.034). Moreover,the ATMSE scores which was used to evaluated the clinicalsymptoms were positively correlated with serum free triiodothyronine(FT3)and free thyroxine(FT4)values(r =0.603,P = 0.013;r = 0.590,P = 0.016).ConclusionThere were abnormal functional changes in the left supple-mentary motor area and the dorsolateral superior frontal gyrus of the patients with ATM and indicated that these ab-errant brain regional activities might lead to the corresponding symptoms of bulbar paralysis in ATM patients.更多还原