摘要
目的利用基于静息态功能磁共振成像(rs-fMRI)技术,研究生长激素缺乏矮小症患者两侧大脑半球之间功能的连接改变,并分析脑功能改变与激素和神经心理学各项指标之间的相关性。方法本研究共纳入儿童内分泌科26例生长激素缺乏(GHD)患儿和44例特发性矮小(ISS)儿童。对所有儿童行3.0 T MR静息态脑功能磁共振成像序列扫描,同时行90项症状清单、儿童行为量表、艾森克人格问卷三项量表测评以评估儿童的认知、情绪,同时收集生长相关激素水平。采用体素-镜像同伦连接(VMHC)方法得到所有受试者大脑半球间功能连接,比较获得两组间VMHC差异脑区,采用Pearson相关分析两组间差异脑区的VMHC值与生长相关激素水平及三大临床量表结果的相关关系。结果与ISS组儿童相比,GHD组儿童的双侧脑岛、壳核、眶额上回的VMHC值显著降低;GHD组脑岛VMHC值与焦虑(r=0.567,P=0.003)、恐怖(r=0.416,P=0.035)评分呈正相关,与内外向评分(r=-0.397,P=0.045)则呈负相关,眶额上回的VMHC值与生长激素基础值呈负相关(r=-0.700,P=0.000)。结论GHD儿童双侧大脑半球间局部脑区的连接功能异常表明生长激素缺乏对儿童大脑网络存在重要影响,主要涉及默认网络、突显网络及执行控制网络,这可能是矮小儿童的认知及情绪改变的潜在原因。
Objective To study the functional connectivity changes between the two cerebral hemispheres in patients with growth hormone deficiency and short stature using resting-state functional magnetic resonance imaging(rs-fMRI)technology,and to analyze the correlation between changes in brain function and hormone and neuropsychological indicators.Methods A total of 26 children with growth hormone deficiency(GHD)and 44 children with idiopathic short stature(ISS)in the Department of Pediatric Endocrinology were enrolled in this study.A 3.0T MR resting-state brain functional magnetic resonance imaging sequence scan was performed on all children.At the same time,a 90-item symptom list,a children′s behavior scale,and an Eysenck personality questionnaire were evaluated to assess children′s cognition and emotions.The growth-related hormone levels were collected.The voxel-mirror homotopy connection(VMHC)method was used to obtain the functional connections between the cerebral hemispheres of all subjects,and the differences in VMHC brain areas between the two groups were compared.Pearson correlation was used to analyze the VMHC values and growth-related hormone levels in the brain areas of the differences between the two groups and the correlation between the results of the three major clinical scales.Results Compared with children in the ISS group,the VMHC values of the bilateral insula,putamen,and superior orbital frontal gyrus of the children in the GHD group were significantly lower.In the GHD group,the VMHC values of the insula were positively correlated with anxiety(r=0.567,P=0.003),horror(r=0.416,P=0.035)scores,and were negatively correlated with inward and outward scores(r=-0.397,P=0.045).The VMHC value of the superior orbitofrontal gyrus was negatively correlated with the basic value of growth hormone(r=-0.700,P=0.000).Conclusion The abnormal connection function of the local brain regions between the bilateral cerebral hemispheres of children with GHD indicates that the lack of growth hormone has an important impact on the children's brain network,mainly involving the default network,the prominent network,and the control network.This may be the underlying cause of cognitive and emotional changes in short children.
作者
蒋乐真
白光辉
刘锟
陈涛
臧依柔
严志汉
JIANG Lezhen;BAI Guanghui;LIU Kun;CHEN Tao;ZANG Yirou;YAN Zhihan(Department of Radiology and Imaging,the Second Affiliated Hospital of Wenzhou Medical University,Yuying Children′s Hospital,Wenzhou 325000,China)
出处
《中国现代医生》
2021年第16期124-129,F0003,共7页
China Modern Doctor
基金
国家自然科学基金资助项目(82071902)
浙江省温州市基础性科研项目(Y20190662)。
关键词
生长激素缺乏症
特发性矮小
静息态功能磁共振
体素-镜像同伦连接
Growth hormone deficiency
Idiopathic short stature
Resting-state functional magnetic resonance
Voxel-mirror image homotopy connection
