【摘要】 目的运用静息态功能磁共振成像(resting state functional MRI,rs-fMRI)技术探讨新疆南疆维吾尔族终末期肾病(end-stage renal disease, ESRD)患者低频振荡振幅(amplitude of low-frequency fluctuation, ALFF)及脑功能连接(functional connectivity,FC)的特点。材料与方法 15例维吾尔族ESRD患者为试验组(ESRD组),20名年龄、性别和受教育年限相匹配的同区域长期居住的健康维吾尔族人为正常对照组,两组均行rs-fMRI检查。采用蒙特利尔认知量表(Montreal Cognitive Assessment,MoCA)评估ESRD患者的认知功能。计算ALFF和基于种子点的FC值,并比较两组间大脑ALFF及FC的差异,采用Pearson相关分析评估ESRD患者异常脑区的ALFF、FC和临床信息的相关关系。结果与对照组比较,南疆维吾尔族ESRD组双侧楔前叶(峰值点在右侧楔前叶)的ALFF(自发活动)减低;通过基于种子点的FC显示ESRD组的右侧楔前叶与右侧楔前叶/双侧中扣带回/双侧后扣带回/右侧内侧眶额叶的功能连接减弱;Pearson相关分析发现患者的右侧楔前叶-右侧内侧眶额叶FC和MoCA认知评分呈显著正相关(r=0.683,P=0.005)。结论南疆维吾尔族ESRD患者的大脑默认网络区域(default mode network,DMN)的自发活动以及功能连接减弱,可能是造成脑功能受损、认知障碍的原因之一。更多还原

【Abstract】 Objective: To investigate the characteristics of amplitude of low frequency fluctuation(ALFF) and brain functional connectivity(FC) in patients with end-stage renal disease(ESRD) in southern of Xinjiang Uyghur autonomous region by using resting-state functional MRI(rs-fMRI). Materials and Methods: Rs-fMRI examinations were performed in 15 Uyghur patients with ESRD and 20 gender-, age-and education-matched healthy Uyghurs who were long-term residents of the same area. The Montreal Cognitive Assessment(MoCA) Scale was used to test the cognitive ability of the ESRD patients. The ALFF and seed-based FC were computed and compared between ESRD patients and healthy controls. The relationships between the altered ALFF or FC and clinical indicators were further assessed in Uyghur ESRD patients by using the Pearson correlation. Results: Compared with control group,ESRD group showed decreased ALFF(spontaneous activity) in the bilateral precuneus(peak location: right precuneus). Seed-based FC analysis showed the FC between right precuneus and the right precuneus, bilateral middle cingulate, bilateral posterior cingulate, right medial orbitofrontal cortex in ESRD group were lower than those of the control group. In the ESRD group, Pearson correlation analysis revealed that the FC between right precuneus and right medial orbitofrontal was positively correlated with the MoCA score(r=0.683, P=0.005). Conclusions: The decreased spontaneous activity and functional connectivity in the default mode network in the Uyghur ESRD may cause brain function impairment and cognitive deficit.更多还原