收稿日期: 2025-03-10
网络出版日期: 2025-07-29
基金资助
国家自然科学基金项目(32260208);石河子大学第一附属医院博士基金项目(BS202210)
Relationship between myelin changes in cerebellar gray matter and cognitive function in PTSD
Received date: 2025-03-10
Online published: 2025-07-29
目的 使用T1加权（T1w）和T2加权（T2w）的比值图像与体素的形态学分析（VBM），探讨创伤后应激障碍（PTSD）患者与健康对照组（HC）小脑灰质髓鞘含量及灰质体积的差异，并分析其差异与认知功能之间的相关性。 方法 本研究共纳入30例PTSD患者（PTSD组）及30例年龄、性别、教育程度匹配的健康志愿者作为HC组，采用蒙特利尔认知评估量表（MoCA）评估PTSD组和HC组的认知功能，随后进行磁共振（MRI）扫描；采用两样本t检验分析小脑灰质区域T1w/T2w比值和灰质体积的组间差异；采用Spearman偏相关分析，探索其组间差异与认知功能的相关性。 结果 与HC组相比，PTSD组左侧小脑灰质T1w/T2w比值降低（体素水平P < 0.001，团块水平P < 0.05， GRF校正）；PTSD组T1w/T2w比值减少区域同时存在灰质体积减少（voxel P < 0.005， cluster P < 0.05， GRF校正）；相关性分析显示，PTSD组左侧小脑灰质T1w/T2w比值与认知障碍严重程度存在正相关。 结论 PTSD患者左侧小脑灰质区域髓鞘含量及灰质体积减少，且髓鞘和体积减少与认知障碍严重程度均呈正相关，T1w/ T2w比值为PTSD患者髓鞘研究提供了新的思路。
李斌 , 胡敏 , 杨罗东 , 张子维 , 胡媛媛 , 张桂青 . 创伤后应激障碍患者小脑灰质髓鞘变化与认知功能的关系[J]. 实用医学杂志, 2025 , 41(14) : 2183 -2190 . DOI: 10.3969/j.issn.1006-5725.2025.14.009
Objective To explore the differences in cerebellar gray matter myelin content and gray matter volume between patients with post-traumatic stress disorder （PTSD） and healthy controls （HC） using the ratio of T1-weighted （T1w） and T2-weighted （T2w） images and voxel-based morphometry （VBM） analysis， and to examine the correlation of these differences with cognitive function. Methods A total of 30 PTSD patients and 30 healthy controls （HC） matched for age， gender， and education level were included in this study. Cognitive function was assessed using the Montreal Cognitive Assessment （MoCA）， and magnetic resonance imaging （MRI） scans were performed for both groups. Two-sample t-tests were used to analyze the group differences in cerebellar gray matter region T1w/T2w ratios and gray matter volume. Spearman partial correlation analysis was used to explore the correlation between the intergroup differences and cognitive function. Results Compared to the HC group， the PTSD group showed a reduced left cerebellar gray matter T1w/T2w ratio （voxel level P < 0.001， cluster level P < 0.05， GRF corrected）. The areas with decreased T1w/T2w ratio in the PTSD group also exhibited reduced gray matter volume （voxel P < 0.005， cluster P < 0.05， GRF corrected）. Correlation analysis revealed a positive correlation between the left cerebellar gray matter T1w/T2w ratio and the severity of cognitive impairment in the PTSD group. Conclusions The PTSD group exhibited reduced myelin content and gray matter volume in the left cerebellar gray matter region， with both myelin reduction and volume loss positively correlating with the severity of cognitive impairment. The T1w/T2w ratio provides a new perspective for studying myelination in PTSD patients.
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