复发性孤立性视神经炎患者初级视觉皮层功能连接的静息态fMRI

目的 采用静息态功能磁共振成像（rs-fMRI）技术，观察复发性孤立性视神经炎（RION）患者初级视觉皮层（V1）与全脑功能连接的改变。方法 收集45例RION患者（RION组）及45名年龄、性别相匹配的健康志愿者（正常对照组）的临床资料，并行常规头部MRI及rs-fMRI，选取V1为种子点，采用统计参数图5（SPM5）分析其与全脑的功能连接，比较两组数据的差异，并将RION组功能连接异常的脑区与其视力、病程及认知功能评分（PASAT）进行相关性分析。结果 与正常对照组相比，RION组左侧额中回、双侧枕叶舌回、右侧颞中回及右侧顶下小叶与V1的功能连接明显减低；双侧楔前叶、右侧额前回、左侧顶下小叶及右侧岛叶与V1的功能连接明显增强，且差异均有统计学意义（P均<0.01）。右侧顶下小叶及右侧额前回的功能连接异常与PASAT评分呈正相关；左侧额中回的功能连接异常与患者视力呈正相关。结论 rs-fMRI可检测出RION患者与V1区功能连接异常的脑区，并且显示与视力、病程及认知功能评分相关的脑区，可为临床探索RION功能连接异常提供客观依据。

Functional MRI of connectivity of primary visual cortex in recurrent isolated optic neuritis patients

Objective To explore the functional connectivity changes of primary visual cortex in recurrent isolated optic neuritis (RION) patients by resting-state functional magnetic resonance imaging (fMRI). Methods All of 45 RION patients and 45 healthy controls matched in age and gender, were enrolled as RION group and control group. All subjects performed neuro-ophthalmologic assessment, routine MRI and resting-state fMRI. The primary visual cortex (V1) was seeded to get the whole brain functional connectivity mapping. The differences of the functional connectivity of V1 were compared between the two groups. The correlation between abnormal functional connectivity of RION patients and their visual acuity, disease durations and cognitive function score (PASAT) were analyzed. Results Compared to control group, RION group showed a decreased functional connectivity between V1 and several brain areas, including left medial frontal gyrus, bilateral lingual gyrus, right middle temporal gyrus and right sub-gyral, while increased in several brain areas including bilateral precuneus, right superior frontal gyrus, left inferior parietal lobule and right insula (all P<0.01). Significant positive correlations between the PASAT scores and the abnormal functional connectivity were identified in the right inferior parietal gyrus and the right frontal gyrus. And significant positive correlations between the visual acuity and the abnormal functional connectivity were identified in the left inferior frontal gyrus. Conclusion Resting-state fMRI can detect abnormal functional connectivity in RION patients, and shows the brain areas associated with visual acuity, disease duration and cognitive function scores, which can provide an objective basis for clinical exploration RION functional connectivity abnormalities.