Objective To analyze the changes of brain structure and function,and face recognition ability in patients with thyroid associated ophthalmopathy(TAO)under the application of brain functional magnetic resonance imaging(fMRI) and face judgment procedure. Methods Sixty-three patients with TAO who met the inclusion criteria were divided into dysthyroid optic neuropathy group and non-thyroid hypertrophic optic neuropathy group according to whether the optic nerve was damaged or not. Functional magnetic resonance imaging,face judgment procedure and voxel based morphometry were used to compare the changes of gray matter density and face recognition ability between the two groups. Results The VBM results in DON group showed that the gray matter density located in the left superior occipital lobe,the left middle occipital lobe, the bilateral inferior temporal gyrus,and the right fusiform gyrus decreased(P<0.001).Non-face,low similarity,high similarity,and face images were regarded as face image probability. The probabilities of the DON group were 0.028,0.062,0.167,and 0.697,respectively,and 0.007,0.047, 0.124,and 0.765 in the NDON group,respectively. The probability was low(P<0.05). There was a positive correlation between the gray matter density of the left superior occipital lobe and the best corrected visual acuity of the right and left eyes(r1=0.435,P1=0.004,r2=0.532,P2=0.000). The gray density of the left middle occipital lobe and the best corrected visual acuity of the right and left eyes had a positive correlation(r3=0.393, P3=0.009,correlation coefficient r4=0.369,P4=0.015). Conclusion In the DON group,the optic nerve was damaged,and the density of gray matter in each region was decreased. The gray matter density of the left occipital lobe and middle lobe have a positive correlation with the best corrected visual acuity. Our study suggests that DON disease may have other mechanism. And this mechanism worked on the central nervous system,which may be relevant with reduced levels of thyroid hormone.%目的 应用脑功能性磁共振成像(fMRI)及面孔判断程序测试分析甲状腺相关性眼病(TAO)患者大脑结构和功能的改变及面孔识别能力的改变.方法 选取符合标准的TAO患者63例,根据视神经是否受损分成视神经损伤组(DON)和非视神经损伤组(NDON),应用脑功能性磁共振成像及面孔判断程序测试检查,应用体素形态学分析技术(VBM)比较两组患者脑灰质密度以及面孔识别能力的改变.结果 VBM结果显示DON组患者左侧枕上叶、左侧枕中叶、双侧颞下回区域,以及右侧前扣带回区域、右侧梭状回区域脑灰质密度下降(P<0.001).将非面孔、低相似度、高相似度、面孔图像判定为面孔的概率,DON组分别为0.028、0.062、0.167、0.697,NDON组为0.007、0.047、0.124、0.765,DON组患者的面孔识别概率较低(P<0.05).左侧枕上叶灰质密度与右眼和左眼的最佳矫正视力分别存在正相关性(r1=0.435、P1=0.004,r2=0.532,P2=0.000).左侧枕中叶灰质密度与右眼和左眼的最佳矫正视力存在正相关性(r3=0.393、P3=0.009,r4=0.369,P4=0.015).结论 DON患者不仅存在视神经的损害,还有多个区域的脑灰质密度的下降.左侧枕上叶、枕中叶灰质密度与最佳矫正视力成正相关性,提示DON的发病可能与甲状腺激素水平减低有关,同时影响中枢神经系统.
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