共同性斜视患者大脑皮层激活强度的功能磁共振研究

目的　采用血氧水平依赖性功能磁共振成像（ｂｌｏｏｄｏｘｙｇｅｎｌｅｖｅｌｄｅｐｅｎｄｅｎｔｆｕｎｃ-ｔｉｏｎａｌｍａｇｎｅｔｉｃｒｅｓｏｎａｎｃｅｉｍａｇｉｎｇ，ＢＯＬＤ-ｆＭＲＩ）技术比较共同性斜视患者与正常受试者在接受不同视差的立体图刺激下激活脑区和激活强度的差异。方法　选取共同性斜视患者１２例，立体视觉正常者１０例，进行组块设计的ｆＭＲＩ研究。采用ＳＰＭ５对数据进行预处理及分析。结果　两组激活强度比较差异有统计学意义（Ｐ＜０．０５）。在视差１２００″刺激下，共同性斜视组激活强度低于正常组的区域表现为双侧枕中回（ＢＡ１８）、双侧额下回（ＢＡ４５／４７）、右侧颞下回（ＢＡ３７）、左侧顶下小叶（ＢＡ４０）、左侧中央后回（ＢＡ２）、左侧岛叶（ＢＡ１３）。在视差２４００″刺激下，共同性斜视组激活强度低于正常组的区域表现为双侧枕中回（ＢＡ１８）、右侧颞下回（ＢＡ３７）、双侧海马（ＢＡ２８）、左侧颞上回（ＢＡ２０）；共同性斜视组激活强度高于正常组的区域表现为右侧舌回（ＢＡ１８）。在视差３６００″刺激下，共同性斜视组激活强度低于正常组的区域表现为右侧额下回（ＢＡ４７）、左侧枕中回（ＢＡ１８）、右侧枕下回（ＢＡ１８）、左侧岛叶（ＢＡ１３）；共同性斜视组激活强度高于正常组的区域表现为右侧额中回（ＢＡ８／１０）。结论　共同性斜视患者右侧舌回、额中回的激活强度高于正常人，双侧枕叶、颞叶、额叶及左侧岛叶、顶叶的激活强度均低于正常人。

Functional magnectic resonance imaging study on cortexactivation intensity in comitant strabismus

Objective To compare cortial activation areas and intensity in comitant strabismus patients and normal subjects in response to the stereogram stimuli using blood oxygen level dependent functional magnetic resonance imaging technology. Methods Twelve subjects with comitant strabismus and 10 normal volunteers were enrolled in the study. The experiment was a block design. Functional MRI data were processed with the statistical parametric mapping 5 software. Results The difference in cortex activation intensity between two groups was statistically significant (P < 0. 05 ) . During the disparity of 1200" RDS stimulus , the significantly lower cortex activation intensity in the strabismus group was observed in bilateral middle occipital gyruses ( BA18) , bialateral inferior frontal gyruses ( BA45/47 ) , right inferior temporal gyrus ( BA37 ) ,left inferior parietal lobule ( BA40) .left postcentral gyrus ( BA2) and left insular lobe ( BA13 ) . During the disparity of 2400" RDS stimulus , the sigruficantly lower cortex activation intensity in the strabismus group was observed in left middle occipital gyrus ( BA18) ,right inferior frontal gyrus ( BA18 ) , right inferior temporal gyrus ( BA37) , bilateral parahippocampal gyruses ( BA28 ) and left superior temporal gyrus ( BA20 ) ; The significantly higher cortex activation intensity in the strabismus group was observed in right lingual gyrus ( BA18 ) . During the disparity of 3600" RDS stimulus . the significantly lower cortex activation intensity in the strabismus group was observed in right inferior frontal gyrus ( BA9/47 ) ,left middle frontal gyrus ( BA18 ) , right inferior occipital gyrus ( BA18) and left insular lobe ( BA13 ) ; The significantly higher cortex activation intensity in the strabismus group was observed in right middle frontal gyrus ( BA8/10) . Conclusiori The cortex activation intensity in right lingual gyrus and middle frontal gyrus of comitant strabismus patients are higher than those of healthy subjects , cortex activation intensity of bilateral occipital lobes . temporal lobes , frontal lobes , left insular lobe and parietal lobe are lower than normal.