J Neurosurg:烟雾病功能学解剖和行为关联之间的初步研究

2016-04-10 MedSci MedSci原创

研究目标:在成人烟雾病(MMD)的患者中慢性额叶血流动力学紊乱和执行力缺损相关。然而,外科血管重建对执行力缺损的影响及其可能的机制尚不明了。这项研究的目的在于调查术后放射相关的认知改善,并由此探索其可能的机制。研究方法:华山医院14位符合入组条件的病人进行手术,并成功随访6个月。术后分别使用SPECT和静息功能磁共振显示皮层灌注改变和低频波动信号(ALFF)。通过连线测验B部分和记忆及执行筛选执行

研究目标:在成人烟雾病(MMD)的患者中慢性额叶血流动力学紊乱和执行力缺损相关。然而,外科血管重建对执行力缺损的影响及其可能的机制尚不明了。这项研究的目的在于调查术后放射相关的认知改善,并由此探索其可能的机制。

研究方法:华山医院14位符合入组条件的病人进行手术,并成功随访6个月。术后分别使用SPECT和静息功能磁共振显示皮层灌注改变和低频波动信号(ALFF)。通过连线测验B部分和记忆及执行筛选执行子测验的得分总和([MES-EX])评价执行功能。随访的神经心理学结局和放射学改变相结合来识别节点函数以引导研究者得出术后执行功能结局。

研究结果:所有病人都进行了成功的单侧旁路手术,有些是左侧有些是右侧。在6个月的随访中,基线和随访的测试分数在不同侧没有明显差异。旁路较好(Matsushima 分级A级)的组有9位病人,术后双侧额叶灌注(血流动力学改变,用[△]表示)显著增加,(左侧,p = 0.009; 右侧, p = 0.003),在左侧顶叶也显著增加(p = 0.014)。斯皮尔曼相关性检验提示只有右侧额叶术后放射学改变能得到显著的认知改变阳性结果(△MES-EX vs △hemodynamics, r = 0.620, p = 0.018; △MES-EX vs △ALFF, r = 0.676, p = 0.008; △hemodynamics vs △ALFF, r = 0.547, p = 0.043).随后局部的低频信号分析提示右背外侧前额皮质(DLPFC)是优势半球表现明显术后改变的唯一节点。研究结论:这个研究结果不仅提高了我们对成年烟雾病患者术后执行力表现病理相互作用的理解,而且提示DLPFC振幅可能是对术后执行力改善的一个定量的预测因子。

原始出处:

Lei Y1, Li YJ1, Guo QH2, Liu XD3, Liu Z3, Ni W1,et al,Postoperative executive function in adult moyamoya disease: a preliminary study of its functional anatomy and behavioral correlates.J Neurosurg. 2016 Apr 8:1-10. [Epub ahead of print]

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  1. [GetPortalCommentsPageByObjectIdResponse(id=87554, encodeId=98ed8e55438, content=烟雾病一直都是治疗的难题, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f9f21613855, createdName=lsblb, createdTime=Mon May 30 17:15:00 CST 2016, time=2016-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78074, encodeId=3ac3e807444, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:27:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78075, encodeId=0485e8075c6, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:27:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1364107, encodeId=1475136410ec5, content=<a href='/topic/show?id=7c5615628ad' target=_blank style='color:#2F92EE;'>#ROS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15628, encryptionId=7c5615628ad, topicName=ROS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=acc3210, createdName=lsndxfj, createdTime=Tue Apr 12 06:48:00 CST 2016, time=2016-04-12, status=1, ipAttribution=)]
    2016-05-30 lsblb

    烟雾病一直都是治疗的难题

    0

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    2016-04-14 李继凯

    文章不错

    0

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    2016-04-14 李继凯

    值得学习

    0

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    2016-04-12 lsndxfj

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