| 袁冬存,洪炎佳,黄穗乔,梁志莹,李兵,薛晓宇.全脑功能连接分析鼻咽癌患者放射治疗后认知障碍[J].中国医学影像技术,2020,36(9):1297~1302 |
| 全脑功能连接分析鼻咽癌患者放射治疗后认知障碍 |
| Analysis of whole-brain functional connectivity of cognitive impairment in nasopharyngeal carcinoma patients after radiotherapy |
| 投稿时间：2019-08-08 修订日期：2020-01-17 |
| DOI：10.13929/j.issn.1003-3289.2020.09.005 |
| 中文关键词: 鼻咽肿瘤 放射治疗 认知障碍 磁共振成像 |
| 英文关键词:nasopharyngeal neoplasms radiotherapy cognition disorders magnetic resonance imaging |
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| 中文摘要: |
| 目的 探讨鼻咽癌患者放射治疗（简称放疗）后认知障碍的全脑功能连接变化。方法 收集76例经病理诊断的鼻咽癌患者，包括放疗后认知障碍组（RT-CI组）20例、放疗后无认知障碍组（RT-No-CI组）34例及未放疗组（No-RT组）22例，记录患者性别、年龄、受教育年限、放疗时间及放疗总剂量，采用北京版蒙特利尔认知评估（MoCA）量表进行认知功能评分。采集脑静息态功能MRI，分析脑功能连接，获得RT-CI组及RT-No-CI组患者脑功能连接异常脑区，比较3组间一般资料及MoCA评分差异，分析脑功能连接异常脑区Z值与MoCA量表评分的相关性。结果 3组年龄（F=2.78，P=0.30）、教育年限（F=3.95，P=0.37）、性别（χ2=3.11，P=0.33）差异无统计学意义。RT-CI组MoCA评分低于RT-No-CI组及No-RT组（P均<0.01），RT-No-CI组MoCA评分低于No-RT组（P<0.01）。相比RT-No-CI组，RT-CI组1对脑区Z值与MoCA量表评分呈正相关（P<0.01）；相比No-RT组，RT-CI组8对脑区Z值与MoCA量表评分相关（P均<0.01）；相比No-RT组，RT-No-CI组5对脑区Z值与MoCA量表评分相关（P均<0.01）。RT-CI组全脑功能连接异常脑区主要位于海马旁回、顶枕叶皮层、前额叶及默认网络区域等；RT-No-CI组则主要位于海马旁回、前额叶及顶叶皮层等。结论 鼻咽癌患者放疗后早期认知障碍可表现为部分特定脑区脑功能连接异常。 |
| 英文摘要: |
| Objective To investigate the changes of whole brain functional connections in cognitively impaired patients with nasopharyngeal carcinoma after radiotherapy. Methods Totally 76 patients with pathologically proved nasopharyngeal carcinoma were collected, including 20 in radiotherapy-cognitive impairment group (RT-CI group), 34 in radiotherapy-no-cognitive impairment group (RT-NO-CI group) and 22 in the no-radiotherapy group (NO-RT group). Patients' gender, age, years of education, radiotherapy time and total measurement of radiotherapy were recorded, and the Beijing Montreal Cognitive Assessment (MoCA) scale was used for cognitive function scoring. Resting brain function MRI were collected, and brain functional connections were analyzed to obtain abnormal brain areas in RT-CI group and RT-NO-CI group. The general data and MoCA scores of 3 groups were compared, and the relationships between Z value of abnormal brain functional connectivity areas and MoCA score were analyzed. Results There was no significant difference of age (F=2.78,P=0.30), years of education (F=3.95, P=0.37)nor gender (χ2=3.11, P=0.33) among 3 groups. MoCA score of RT-CI group was lower than that of RT-NO-CI group and NO-RT group (both P<0.01), and MoCA score of RT-NO-CI group was lower than that of NO-RT group (P<0.01). Compared with RT-NO-CI group, there was positive correlation between Z value of 1 pair of brain region and MoCA scale score in RT-CI group (P<0.01). Compared with NO-RT group, Z values of 8 pairs of brain areas in RT-CI group were correlated with MoCA scale scores (all P<0.01). Compared with NO-RT group, Z values of 5 pairs of brain areas in RT-NO-CI group were correlated with MoCA scale scores (all P<0.01). In RT-CI group, brain areas with abnormal functional connections mainly located in parahippocampal gyrus, parietal occipital cortex, prefrontal cortex and default mode network area. In RT-No-CI group, brain areas with abnormal functional connections mainly located in hippocampal gyrus, prefrontal lobe and parietal cortex. Conclusion Early cognitive impair in patients with nasopharyngeal carcinoma after radiotherapy might manifest as abnormal brain functional connectivity in some specific brain regions. |
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