目的 利用基于体素的功能连接密度(functional connectivity density,FCD)图方法观察视神经脊髓炎(neuromyelitis optica,NMO)患者静息状态下脑网络水平各脑区重要程度的异常改变,并评价其与临床评分、病程等的相关性.材料与方法 搜集20例NMO患者及20例年龄、性别相匹配的健康志愿者静息态功能磁共振(resting state functional MRI,rs-fMRI)数据,所得数据利用基于Matlab平台的DPARSFA软件进行图像预处理,然后利用其度中心度(degree centrality,DC)选项计算出FCD值,用SPM8软件进行平滑处理,得到二值化的平均FCD值,组间进行双样本t检验比较两组之间FCD有差异的脑区,分析有差异的脑区FCD值与临床扩展残疾评分量表(expanded disability status scale,EDSS)评分及病程的相关性.结果 与健康对照组相比,NMO患者FCD增加的脑区以左侧小脑半球(下半月小叶)为主;FCD减低的脑区主要包括双侧额叶(BA 11)、左侧舌回、双侧小脑半球(方形小叶后部)(P<0.001,未校正,体素>30).NMO患者的病程与左侧小脑半球(下半月小叶)FCD呈正相关(r=0.6,P=0.005).结论 NMO患者脑功能网络连接属性存在异常,表现为多个脑功能区FCD增高或减低,可能与NMO患者肢体及认知功能障碍发生的神经病理机制有关.%Objective: Using a novel functional connectivity density (FCD) approach to investigate the strength of intrinsic connectivities alternations in neuromyelitis optica (NMO) patients at resting-state, and the correlation with clincal scores and duration. Materials and Methods: A total of 20 NMO patients and 20 sex- and age-matched healthy controls underwent resting-state functional MRI (rs-fMRI) examinations. Data of rs-fMRI were measured on DPARSFA (based on Matlab station) by using degree centrality method (threshold value was 0.25). Analysis of FCD map between the patient group and the control group were performed by two sample t test (P<0.001, uncorrected, voxels>30). Correlation analysis was performed for regions with FCD value statistically different in NMO with clinical parameters. Results: Compared with the control group, NMO patients showed significantly increased FCD in the left cerebellum crus and decreased FCD in the bilateral frontal lobe (BA 11), bilateral cerebellum 6 and left lingual gyrus. Moreover, the FCD values of the left cerebellum crus was correlated with duration (r=0.6, P=0.005). Conclusions: NMO patients have abnormal brain function network connection properties, which show that the increase or decrease of FCD in multiple brain functional areas may be related to the neuropathologic mechanism of the limb and cognitive dysfunction of NMO patients.
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