基于静息态功能磁共振成像的肝性脑病患者脑功能网络连接

目的 采用静息态fMRI技术观察肝性脑病(HE)患者双侧苍白与全脑网络连接的改变。方法 收集21例明显HE患者(OHE组)、22例轻微型HE患者(MHE组)及21名健康志愿者(HC组)行静息态fMRI,选择双侧苍白球作为种子点,利用种子体素相关性脑功能网络分析方法对数据进行处理并进行统计学分析。结果 3组间脑网络连接差异的脑区主要位于额叶、颞叶、双侧尾状核及顶叶(P均<0.05)。与HC组比较,OHE组右侧梭状回、右侧枕下回、左侧眶部额上回、右侧额中回等脑区连接减弱,在双侧尾状核、左三角部额下回、左海马旁回等脑区连接增强;MHE组双侧颞中回、左中央前回、左内侧额上回等脑区连接减弱;与MHE组比较,OHE组右梭状回、右侧楔前叶、右侧颞中回、右侧角回连接减弱,右侧颞下回、双侧尾状核连接增强(P均<0.05)。结论 OHE及MHE患者皮层与皮层下区域脑功能网络连接存在异常,HE患者认知功能障碍可能与功能网络连接改变有关。

Brain functional connectivity in patients with hepatic encephalopathy based on resting-state fMRI

Objective To explore the whole brain connectivity network associated with bilateral globus pallidus in hepatic encephalopathy(HE) patients with resting-state fMRI(rs-fMRI). Methods Twenty-one patients with previous overt HE(OHE group), 22 patients with minimal HE(MHE group) and 21 healthy controls(HC group) underwent rs-fMRI. The bilateral resting-state networks(RSNs) were characterized using a standard seed-based whole-brain correlation method, and the statistical analysis was performed. Results There were different functional connectivities among three groups mainly included the frontal lobe, temporal lobe, bilateral caudate nucleus and parietal lobe(all P<0.05). Compared with the HC group, the OHE group showed decreased functional connectivity in the right fusiform gyrus, right inferior occipital gyrus, left superior orbitofrontal gyrus, right middle frontal gyrus, and increased functional connectivity of bilateral caudate nucleus, triangle inferior frontal gyrus, left parahippocampal gyrus, the MHE group showed decreased functional connectivity in the bilateral middle temporal gyrus, left precentral gyrus, left medial frontal gyrus. Compared with the MHE group, the OHE group showed decreased functional connectivity of right fusiform gyrus, right precuneus, right middle temporal gyrus, right angular gyrus, and increased functional connectivity in the right inferior tempotal gyrus, bilateral caudate nucleus(all P<0.05). Conclusion Both of OHE and MHE patients exist disrupted functional connectivity between cortex and subcortex areas. The changes of the functional connectivity may associate with cognitive dysfunction in patients with HE.