摘要
目的:探讨右眼屈光参差性弱视患儿静息状态下大脑功能活动的变化机制。方法:系列病例研究。连续性选择2020年8月至2021年12月在郑州大学第一附属医院诊断为右眼屈光参差性弱视的患儿17例作为弱视组,男9例,女8例,年龄(9.2±2.3)岁。同时,选择16例双眼视力正常的儿童作为对照组,男7例,女9例,年龄(10.4±2.0)岁。所有受检儿童进行静息态功能磁共振成像扫描,联合局部一致性(ReHo)和度中心性(DC)的方法进行脑功能机制的分析。组间比较采用基于体素层面的独立样本t检验。脑区的平均ReHo值和DC值与临床特征的相关性使用偏相关分析。采用受检者工作特征(ROC)曲线法分析2组间特异脑区平均ReHo值和DC值的差异。结果:与对照组相比,弱视组在左顶下缘角回、左后扣带回、左枕中回、右眶部额下回、右背外侧额上回、右内侧额上回、右距状裂周围皮层、左枕上回、左额中回、右楔前叶和右中央前回的ReHo值差异有统计学意义(t=4.72、4.39、3.83、4.37、4.09、3.83、-4.22、-5.26、-4.93、-6.75、-4.74;体素水平P<0.01,簇水平P<0.05);在左枕上回、右中央前回、左顶上回、左距状裂周围皮层和右楔前叶的DC值差异有统计学意义(t=6.43、4.10、4.29、-3.57、-5.10;体素水平P<0.01,簇水平P<0.05)。偏相关分析显示,弱视组左枕上回DC值与右眼最佳矫正视力(BCVA),右距状裂周围皮层ReHo值与左眼眼压,右中央前回ReHo值与右眼BCVA之间均呈正相关(r=0.62、0.56、0.53,P<0.05);右眶部额下回ReHo值与右眼眼压之间呈负相关(r=-0.57,P=0.027)。ROC曲线分析显示,左后扣带回和右眶部额下回ReHo值差异有统计学意义(ROC曲线下面积分别为:0.81、0.81;P=0.002、0.002);右内侧额上回ReHo值差异有统计学意义(ROC曲线下面积为0.73,P=0.023)。结论:右眼屈光参差性弱视患儿存在异常内在或自发的大脑神经元活动区域及相关脑区功能网络的异常改变,提示相应脑区的功能可能受损。
Objective:To explore the abnormal changes of brain function mechanism in children with right eye anisometropic amblyopia during the resting state.Methods:In this case series study,17 children with right eye anisometropic amblyopia were enrolled in the First Affiliated Hospital of Zhengzhou University from August 2020 to December 2021.The average age of the patients was 9.2±2.3 years of which 9 were males and 8 were females.Sixteen children with normal binocular vision were selected as the control group.The average age of the control subjects was 10.4±2.0 years of which 7 were males and 9 were females.The resting-state functional magnetic resonance imaging was examined.Brain function mechanism was analyzed by using combined regional homogeneity(ReHo)and degree centrality(DC).A two-sample t test based on voxel level was performed.A partial correlation was used to analyze the correlation between mean ReHo and mean DC values in brain regions and clinical features,and receiver operating characteristic(ROC)curve method was used to analyze the differences of mean ReHo and mean DC values of specific brain regions in different groups.Results:Inter-group comparison between controls and patients have demonstrated that ReHo in left inferior parietal border angular gyrus,left posterior cingulate gyrus,left middle occipital gyrus,right orbital inferior frontal gyrus,right dorsolateral superior frontal gyrus,right medial superior frontal gyrus,right calcarine fissure surrounding cortex,left superior occipital gyrus,left middle frontal gyrus,right precuneus and right precental gyrus was widespread differences(t=4.72,4.39,3.83,4.37,4.09,3.83,-4.22,-5.26,-4.93,-6.75,-4.74;Voxel level P<0.01,Cluster level P<0.05);DC in left superior occipital gyrus,right precental gyrus,left superior parietal gyrus,left calcarine fissure surrounding cortex,and right precuneus was widespread differences(t=6.43,4.10,4.29,-3.57,-5.10;Voxel level P<0.01,Cluster level P<0.05).Partial correlation analysis showed:the DC of left superior occipital gyrus vs.BCVA of right eye,the ReHo of right calcarine fissure surrounding cortex vs.intraocular pressure of left eye,the ReHo of right precental gyrus vs.BCVA of right eye was a positive correlation(r=0.62,0.56,0.53;P<0.05);while the ReHo of right orbital inferior frontal gyrus vs.intraocular pressure of right eye was a negative correlation(r=-0.57,P=0.027).ROC analysis have demonstrated ReHo in left posterior cingulate gyrus,right orbital inferior frontal gyrus and right medial superior frontal gyrus was statistically differences(The areas under the ROC curve=0.81,0.81;P=0.002,0.002;The areas under the ROC curve=0.73,P=0.023).Conclusions:Children with right eye anisometropia amblyopia had abnormal intrinsic or spontaneous changes in brain neuron activity areas,and variations in functional networks being related brain regions,suggesting that the corresponding brain areas may be impaired.
作者
张晓盼
李亚东
郑广瑛
文宝红
程敬亮
Xiaopan Zhang;Yadong Li;Guangying Zheng;Baohong Wen;Jingliang Cheng(Department of Magnetic Resonance Imaging,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2023年第3期174-181,共8页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
河南省重点研发与推广专项(科技攻关)(222102310317,232102310094)
郑州大学第一附属医院院内青年创新基金项目(YNQN2017160)。
关键词
屈光参差性弱视
静息态功能磁共振成像
局部一致性
度中心性
anisometropic amblyopia
resting-state functional magnetic resonance imaging
regional homogeneity
degree centrality
