AIDS病痴呆综合征可伴广泛的中枢和周围神经系统受损以神经认知.DOC

DTI和rs-fMRI联合应用对AIDS轻度认知功能下降的初步研究 【摘要】 目的 应用DTI和rs-fMRI及两种图像融合技术探讨AIDS轻度认知功能下降白质损害与皮层功能区损害的分布及相互关系。 方法 对26例经MoCA量表评估的AIDS轻度认知功能下降患者和30例健康自愿者，行全脑DTI和rs-fMRI检查，获得全脑FA值降低脑区分布图和以后扣带回为种子点静息态默认模式网络脑功能连接图，并采用图像融合技术将两组图像进行融合。 结果 AIDS组脑白质FA值降低脑区为左侧楔前叶和右侧楔前叶、额上回、额中回、中央前回、枕叶、顶下小叶(p0.005)；静息态与后扣带回功能连接相关脑区为左侧扣带回、楔前叶、额上回、颞中回、颞下回、海马旁回和右侧后扣带回、楔前叶、额上回、额中回、颞上回、颞中回(p0.005)；与后扣带回功能连接减弱脑区为左侧楔前叶，前扣带回、小脑扁桃体和右侧顶上小叶、海马旁回、小脑扁桃体(p0.01)。图像融合AIDS组左侧楔前叶脑白质FA值降低脑区其皮层功能活动显著减弱；左侧楔前叶，右侧楔前叶、额上回、额中回FA值减低脑区其皮层功能活动受影响不大。 结论 多个脑区脑白质神经纤维失连接及相关联皮层功能活动下降及代偿共同参与了AIDS轻度认知功能下降的发病过程。 【关键词】 HIV; 认知功能; 脑;　磁共振成像;　弥散;　各向异性;　功能连接;　默认状态网络;　静息态 HIV-associated mild cognitive function decline: a preliminary study of the combination of diffusion tensor imaging and resting-state functional magnetic resonance imaging 【Abstract】Objective The diffusion tensor imaging(DTI) can early show the mild damage of the white matter, while the resting-state functional magnetic resonance imaging(rs-fMRI) can early showed the damage of the cortical functional areas in AIDS patients with cognitive functional decline, so the purpose of this study was to observe the distribution and relationship of white matter lesions and cortical functional areas in HIV patients with mild cognitive decline by using the DTI and the rs-fMRI methods. Methods 26 HIV patients with mild cognitive impairment and 30 healthy volunteers were selected by the montreal cognitive assessment (MoCA) scale evaluation and the DTI data and resting-state fMRI data were obtained, the fractional anisotropy (FA) value image was obtained with the voxel based analysis and the resting-state default mode network(DMN) functional connectivity image was obtained with the cingulate gyrus as a seed point. An overlay image was obtained with FA image, DMN image and Ch2 standard image. Results Compared with the control group, the white matter FA values significantly decreased in the left precuneus and right precuneus, superior frontal gyrus, middle frontal gyrus, precentr