摘要
背景:嗅觉功能异常是许多疾病的早期生物学标志物,但脑小血管病的嗅觉功能异常发生的神经影像机制尚且不清。目的:探索脑小血管病与帕金森病患者嗅觉功能调控的不同神经影像学机制,探讨嗅觉功能评估在脑小血管病患者中的潜在应用价值。方法:对80例脑小血管病患者、44例健康对照及29例帕金森病患者行神经心理学及嗅觉测试、高分辨率结构磁共振及静息态功能磁共振扫描。应用DPABI、SPM12、SPSS软件分析脑小血管病、帕金森病患者及健康对照组静息态功能磁共振低频振幅、局部一致性及功能连接的异同,并分析静息态功能磁共振的影像指标与嗅觉和认知评分的相关性。结果与结论:①与对照组相比,脑小血管病、帕金森病组右侧背外侧额上回低频振幅、左侧楔叶局部一致性显著降低;②右侧背外侧额上回及左侧楔叶为种子点,与帕金森病组相比,右侧楔前叶、颞下回、中央前回及背外侧额上回、左侧中央后回及颞下回功能连接在对照、脑小血管病组中显著增强;③左侧楔叶为种子点,与对照组相比,左侧舌回功能连接在脑小血管病、帕金森病组明显减弱;左侧颞中回及右侧中央后回功能连接在对照组较脑小血管病、帕金森病组增强,脑小血管病组较帕金森病组增强;④相关性分析显示,脑小血管病组嗅觉评分与认知评分呈正相关,且左侧楔叶的局部一致性与蒙特利尔认知评估量表评分负相关,帕金森病组中左侧楔叶-左侧颞中回功能连接值与嗅觉识别评分呈正相关,左侧楔叶-左侧中央后回、左侧楔叶-左侧舌回的功能连接值分别与嗅觉识别评分及嗅觉总分呈正相关;⑤提示脑小血管病患者嗅觉功能调控存在不同于帕金森病患者嗅觉障碍的神经影像机制,脑小血管病患者的嗅觉功能与认知功能相关,推测脑小血管病嗅觉功能异常是脑功能异常的继发性改变,而帕金森病嗅觉障碍是由嗅觉相关脑区功能异常直接引起的;脑小血管病患者嗅觉功能评估在预测认知功能方面有潜在应用价值。
BACKGROUND:Olfactory dysfunction is an early biological marker of various diseases.However,the neuroimaging mechanism by which olfactory dysfunction occurs following cerebral small vessel disease is unclear.OBJECTIVE:To explore the different neuroimaging mechanisms of olfactory function regulation in patients with cerebral small vessel disease and Parkinson’s disease,and explore the potential application value of olfactory function assessment in patients with cerebral small vessel disease.METHODS:Neuropsychological and olfactory tests,high-resolution structural magnetic resonance and resting-state functional magnetic resonance data were collected in 80 patients with cerebral small vessel disease,44 healthy controls and 29 patients with Parkinson’s disease.DPABI,SPM12 and SPSS were used to analyze and compare the amplitude of low frequency fluctuation,regional homogeneity and functional connectivity values between the cerebral small vessel disease,control and Parkinson’s disease groups.Correlations between the significantly altered resting-state functional magnetic resonance imaging measures and olfactory and cognitive scores were evaluated.RESULTS AND CONCLUSION:Compared with the control group,low-frequency fluctuation amplitude of the right dorsolateral superior frontal gyrus and the regional homogeneity of the left wedge leaf were significantly reduced in the cerebral small vessel disease and Parkinson’s disease groups.The right dorsolateral superior frontal gyrus and the left cuneiform lobe are the seed points.Compared with the Parkinson’s disease group,the functional connectivity values of the right anterior cunei,inferior temporal gyrus,anterior central gyrus and dorsolateral superior frontal gyrus,left posterior central gyrus and inferior temporal gyrus were significantly enhanced in the control and cerebral small vessel disease groups.The left cuneiform lobe was the seed point.Compared with the control group,the functional connectivity of the left lingual gyrus was significantly weakened in the cerebral small vessel disease and Parkinson’s disease groups.The functional connectivity values of the left middle temporal gyrus and the right posterior central gyrus were enhanced in the control group compared with the cerebral small vessel disease and Parkinson’s disease group,and that was enhanced in the cerebral small vessel disease group compared with the Parkinson’s disease group.Correlation analysis showed that the olfactory score and cognitive score were positively correlated in the cerebral small vessel disease group,and the regional homogeneity of the left wedge lobe was negatively correlated with the Montreal Cognitive Assessment Scale score,while the functional connectivity of left wedge lobe-left middle temporal gyrus in the Parkinson’s disease group was positively correlated with the olfactory recognition score,and the functional connectivity values of the left wedge lobe-left posterior central gyrus and left wedge lobe-left lingual gyrus were positively correlated with the olfactory identification score and the total olfactory score,respectively.The regulation of olfactory function in patients with cerebral small vessel disease has a different neuroimaging mechanism from that of olfactory dysfunction in patients with Parkinson’s disease.The olfactory function of patients with cerebral small vessel disease is related to cognitive function.It is speculated that the olfactory function following cerebral small vessel disease is a secondary change of brain dysfunction,while olfactory dysfunction following Parkinson’s disease is directly caused by abnormal function of olfactory-related brain areas.Olfactory function assessment in patients with cerebral small vessel disease has potential application in predicting cognitive function.
作者
黄中霞
王雨
刘雅文
张小旭
徐丹丹
杨艳萍
黄明明
余晖
Huang Zhongxia;Wang Yu;Liu Yawen;Zhang Xiaoxu;Xu Dandan;Yang Yanping;Huang Mingming;Yu Hui(School of Medical Imaging,Guizhou Medical University,Guiyang 550004,Guizhou Province,China;Department of Radiology,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2024年第20期3209-3215,共7页
Chinese Journal of Tissue Engineering Research
基金
贵州医科大学附属医院国基培育项目(8206070224),项目负责人:余晖。
关键词
静息态功能磁共振成像
脑小血管病
嗅觉功能
认知功能
功能连接
resting-state functional magnetic resonance imaging
cerebral small vessel disease
olfactory function
cognition
functional connectivity
