摘要
目的应用基于体素形态学测量(VBM)研究先天感音神经性耳聋(CSNHL)患儿脑灰质密度与人工电子耳蜗植入(CI)术后语言恢复的相关性,探讨CSNHL相关脑重塑性机制。方法收集117例CSNHL患儿磁共振资料,CI术后6个月随访患儿言语可懂度分级标准(SIR)评分,将患儿分成三组(高、中、低分组)。运用数据处理助手DPARSFA 3.2及统计参数图软件包SPM 12软件分析患者磁共振结构像资料,采用单因素方差分析(One-way ANOVA)分析与组间多重比较分析患儿脑灰质密度资料,从而获得差异显著性的脑区,并运用SPSS 16.0软件将部分脑区的脑灰质密度效应值与SIR分数进行相关性分析。结果三组患者脑灰质密度差异显著性的脑区主要有:左侧额上下回、左侧前扣带回、后扣带回、左侧枕下回、双侧梭状回、右侧颞上回(P<0.005);上述脑区脑灰质密度效应值与SIR分数均具有相关性(P<0.05)。组间多重比较分析,高分组比低分组脑灰质密度增加的脑区有:左侧额下回、左侧中央后回、左侧缘上回、右侧颞中回、后扣带回;高分组比中分组脑灰质密度增加的脑区有:双侧额上回、左侧中央前回、右侧中央后回、右侧颞上回、右侧距状沟皮层、左侧楔前叶、双侧梭状回、后扣带回、左侧枕下回、双侧壳核、右侧丘脑(P<0.001)。结论CSNHL患儿术后语言恢复水平与术前视听觉皮层和默认网络等相关脑区灰质密度改变显著相关,这可能与相关脑区的神经重塑性有关联。
Objective To explore the neural remodeling mechanism of congenital sensorineural hearing loss（CSNHL）,correlations of the brain grey matter density and the speech intelligibility were investigated in children of post-operation of artificial electronic cochlear implantation（CI） by using voxel-based morphometry（VBM）.Methods MRI data of congenital deafness were collected from 117 children suffering from congenital acoustic neural hearing loss,whom were divided into three groups according to the standard of speech intelligibility（SIR） assessed from post-CI children by 6-month follow-up.SPM 12 and DPARSFA 3.2 software were used to analyze MRI data of patients.One-way ANOVA analysis and multiple comparisons were performed to analyze the differences of brain gray matter density between all groups.The correlations were also analyzed by SPSS 16.0 software.Results There were significant density difference in brain areas including left upper frontal gyrus,left inferior frontal gyrus,left anterior cingulate gyrus,posterior cingulate gyrus,left occipital gyrus,bilateral fusiform gyrus,right superior temporal gyrus（P0.005）.The density of these areas were all significantly correlated with SIR score（P0.05）.Multiple comparison analysis showed that the density in the higher score group was higher than that in the lower group in brain areas including the left supramarginal gyrus,the left central posterior gyrus,the left supramarginal gyrus,the right middle temporal gyrus,and the posterior cingulate gyrus.Density of the higher score group was higher than that of the medium scores group in brain areas including bilateral superior frontal gyrus,left precentral gyrus,right postcentral gyrus,right superior temporal gyrus,right calcarine cortex,left precuneus,bilateral fusiform gyrus,posterior cingulate gyrus,left occipital gyrus,left putamen,right thalamus（P0.001）.Conclusion The level of postoperative speech recovery in pediatric congenital sensorineural hearing loss is significantly correlated with changes of brain gray matter density of visual-auditory cortex and brain regions of default mode network,which may be associated with the neural remodeling of the relative brain regions.
作者
马宁
王海宝
余永强
宋彪
刘灿
吴德
童步升
Ma Ning;Wang Haibao;Yu Yongqiang(Dept of Radiology,The First Affiliated Hospital of Anhui Medical University,Hefei 23002)
出处
《安徽医科大学学报》
CAS
北大核心
2018年第7期1067-1071,共5页
Acta Universitatis Medicinalis Anhui
基金
国家自然科学基金项目(编号:81171326
81571308
81771817)
关键词
先天性感音神经性耳聋
言语可懂度
脑灰质密度
基于体素形态学测量
磁共振成像
congenital sensorineural hearing loss
speech intelligibility
grey matter density
voxel-based morphometry
magnetic resonance imaging
