终末期肾病患者默认网络功能连接上的空间分解与中断

摘要

Objective To investigate the abnormal functional connectivity of the default mode network (DMN) in patients with end-stage renal disease (ESRD) and their clinical relevance.Methods Resting-state functional magnetic resonance imaging (RfMMRI) data were collected from 31 ESRD patients and 31 age-and gender-matched healthy controls.A whole-brain seed-based functional connectivity analysis was performed by locating the seeds in the posterior cingulate cortex (PCC) and ventromedial prefrontal cortex (vmPFC) to investigate the functional connectivity of the posterior and anterior DMN over the whole brain,respectively.Results Compared to the healthy controls,the ESRD patients exhibited significantly decreased functional connectivity with the PCC in the left middle temporal gyrus,the right anterior cingulate gyrus,and the bilateral medial superior frontal gyrus.For the vmPFC seed,only the right thalamus showed significantly decreased functional connectivity in ESRD patients,compared with healthy controls.The functional connectivity between the PCC and right medial superior frontal gyrus showed a significantly positive correlation with the hemoglobin level in ESRD patients.Conclusion The DMN in ESRD patients shows space decomposition and disruptions of functional connectivity.%目的:研究终末期肾病患者脑默认网络异常的功能连接及其临床意义.方法:收集31例终末期肾病患者和31例年龄和性别相匹配的健康对照组静息态脑功能数据.应用基于种子点的分析方法行全脑功能连接分析,分别以后扣带回皮层和腹内侧前额叶皮层为种子点研究全脑前、后默认网络的功能性连接.结果:与对照组比较,终末期肾病患者表现出左侧颞中回、右侧前扣带回及双侧额上回内侧与后扣带回的功能连接上明显降低.当以腹内侧前额叶皮层为种子点,患者出现右侧丘脑功能性连接明显下降.此外,患者的后扣带回和右额上回内侧的功能连接与血红蛋白水平表现出显著正相关.结论:终末期肾病患者的脑默认网络呈现出空间连接上的紊乱.