抗N-甲基-D-天冬氨酸受体脑炎伴认知损伤患者的脑功能低频振幅及局部一致性的变化

doi:10.3969/j.issn.1006-5725.2023.20.008

Abstract

Abstract:

Objective To use resting?state functional magnetic resonance imaging （rs?fMRI） to study amplitude of low?frequency ?uctuation （ALFF） and regional homogeneity （ReHo） changes in brain function in patients with anti?N?methyl?D?aspartate receptor encephalitis with cognitive impairment （ANMDARE?CI）. Methods A total of 33 patients with anti?N?methyl?D?aspartate receptor encephalitis （ANMDARE） and 18 healthy volunteers （Controls） underwent rs?fMRI， the Beijing version of the Montreal Cognitive Assessment （MoCA?B） and neuropsychological scales. The cognitively impaired （ANMDARE?CI， n = 17） and the cognitively normal （ANMDARE?CN， n = 16） were divided according to the assessment of the MoCA?B scale. Differences in brain activity between the ANMDARE?CI， ANMDARE?CN and control were analysed using ReHo and ALFF. One?way ANOVA was performed using SPM12， ReHo and ALFF values for differential brain regions were extracted for independent samples t?tests for two?way comparisons and correlation analysis between clinical data and ANMDARE scales. Results Compared with ANMDARE?CN and Control， in ANMDARE?CI，ALFFs of bilateral cerebellar were reduced， and the right superior frontal gyrus and left central anterior gyrus ALFF were increased （P < 0.01）. Compared to Controls， in ANMDARE?CI and ANMDARE?CN， ALFFs of bilateral thalamus and ReHo of the right anterior cerebellar lobe were decreased （P < 0.01）. ReHo of Left Anterior Cingulate in ANMDARE?CN was significantly lower than ANMDARE?CI and Controls （P < 0.01）. Increased ALFF values on the right superior frontal gyrus were inversely correlated with MoCA?B performance scores （r = -0.586， P = 0.013）. Increased left central anterior gyrus ALFF was negatively correlated with the MoCA?B directional score （r = -0.668， P = 0.003） and positively correlated with HAMA （r = 0.665， P = 0.004）. No correlation between ReHo values and clinical data was found （P > 0.016）. Conclusions Abnormal brain function in ANMDARE_CI may be associated with altered spontaneous cerebellar activity.

Key words: anti?N?methyl?D?aspartate receptor encephalitis, cognitive impairment, functional magnetic resonance imaging, amplitude of low?frequency ?uctuation, regional homogeneity

CLC Number:

R512.3

Dongying HUANG,Caitiao LV,Zhekun LI,Qijia LONG,Jin′ou. ZHENG. Changes in brain function using regional homogeneity and amplitude of low⁃frequency ﬂuctuation methods in patients with anti⁃N⁃methyl⁃D⁃aspartate receptor encephalitis with cognitive impairment[J]. The Journal of Practical Medicine, 2023, 39(20): 2603-2607.

Figures/Tables 4

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Tab.2

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References 20

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项目	Control组（n = 18）	ANMDARE-CN组（n = 16）	ANMDARE-CI组（n = 17）	P值
年龄（岁）	30.8 ± 9.9	23.6 ± 5.9	29.5 ± 11.5	0.077
性别（男/女，例）	7/11	5/11	8/9	0.649
教育年限（年）	13.9 ± 4.1	12.6 ± 2.9	9.9 ± 3.9^a*	0.009
MoCA总分	28.4 ± 2.0	27.9 ± 1.3	21.6 ± 4.6^*△	< 0.001
HAMA评分	0.9 ± 1.6	3.1 ± 3.6	4.5 ± 2.9^*	0.001
HAMD₂₄评分	1.1 ± 1.7	5.1 ± 6.4^a	5.5 ± 4.8^*	0.002
执行	0.9 ± 0.3	0.9 ± 0.3	0.5 ± 0.5^*	0.021
流畅性	1.7 ± 0.6	1.6 ± 0.6	0.7 ± 0.5^*△	< 0.001
定向	5.9 ± 0.2	5.8 ± 0.4	5.2 ± 1.4	0.078
计算	2.9 ± 0.2	3.0 ± 0.0	2.2 ± 1.1^*△	< 0.001
抽象	2.8 ± 0.4	2.7 ± 0.7	1.18 ± 1.1^*△	< 0.001
延迟回忆	4.2 ± 1.0	3.4 ± 1.2	2.3 ± 1.2^*△	0.001
视知觉	3.0 ± 0.2	2.9 ± 0.3	2.3 ± 0.8^*△	0.001
命名	3.9 ± 0.3	4.0 ± 0.0	3.6 ± 0.5^△	0.006
注意	2.8 ± 0.5	3.0 ± 0.0	2.8 ± 0.7	0.554
病程（年）	-	1.3 ± 1.2	1.9 ± 1.3	0.188

AAL脑区	体素数目	MNI坐标			F值^*	ANMDARE-CI vs. ANMDARE-CN（t）	ANMDARE-CI vs. Controls（t）	ANMDARE-CN vs. Controls（t）
AAL脑区	体素数目	X	Y	Z	F值^*	ANMDARE-CI vs. ANMDARE-CN（t）	ANMDARE-CI vs. Controls（t）	ANMDARE-CN vs. Controls（t）
ALFF
左侧小脑后叶	272	9	-48	-33	4.280 6	-2.976^△	-8.135^△	-1.830
右侧小脑前叶	50	18	-45	-21	3.408 3	-3.064^△	-4.675^△	-0.019
左侧丘脑	78	-12	-15	0	4.238 2	-0.814	-3.451^△	-2.986^△
右侧丘脑	86	15	-15	0	4.322 5	-0.243	-4.376^△	-3.932^△
右侧额上回	174	3	6	66	4.112 1	5.160^△	5.297^△	-0.650
左侧中央前回	64	-21	-15	69	4.524 8	3.259^△	4.202^△	1.355
ReHo
左侧小脑前叶	39	-33	-45	-24	3.563 6	-2.311	2.461	4.454^△
右侧小脑前叶	95	33	-33	-27	4.166 3	-0.759	5.808^△	6.500^△
左前扣带回	64	-6	30	-3	3.847 5	4.224^△	0.491	-4.008^△

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Changes in brain function using regional homogeneity and amplitude of low⁃frequency ﬂuctuation methods in patients with anti⁃N⁃methyl⁃D⁃aspartate receptor encephalitis with cognitive impairment

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