Ni Ling, Liu Renyuan, Yin Zhenyu, Zhao Hui, Nedelska Zuzana, Hort Jakub, Zhou Fei, Wu Wenbo, Zhang Xin, Li Ming, Yu Haiping, Zhu Bin, Xu Yun, Zhang Bing
Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
Department of Neurology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
J Alzheimers Dis. 2016;50(4):1243-54. doi: 10.3233/JAD-150622.
Lacunar infarctions (LI) have been associated with a cognitive decline and an increased risk of dementia. Whether and how the pattern of spontaneous brain activity in patients with mild cognitive impairment (MCI) differs in subjects with and without concomitant LI remains unclear.
To compare the pattern of spontaneous brain activity in MCI patients with versus those without LI using resting-state functional magnetic resonance imaging (rs-fMRI).
Forty-eight MCI patients, including 22 with LI [MCI-LI] and 26 without LI [MCI-no LI], and 28 cognitive normal subjects underwent rs-fMRI post-processed using regional homogeneity (ReHo) and the amplitude of low-frequency fluctuation (ALFF) methods.
Compared with cognitively normal subjects, the MCI-LI patients had decreased ReHo in the precuneus/cuneus (Pcu/CU) and insula; decreased ALFF in the Pcu/CU and frontal lobe; and increased ALFF and ReHo in the temporal lobe. While the MCI-no LI group had increased ReHo and ALFF in the bilateral hippocampus and parahippocampal gyrus, frontal lobe, and decreased ALFF and ReHo in the temporal lobe. Compared with the MCI-no LI patients, those with MCI-LI had decreased ALFF in the frontal lobe; decreased ReHo in the Pcu/CU and insula; and increased ALFF and ReHo in the temporal lobe (p < 0.05, AlphaSim corrected). In MCI-LI patients, the MOCA scores showed a relatively weak correlation with ALFF values in the medial frontal gyrus (r = 0.432, p = 0.045) (of borderline significance after Bonferroni correction).
The spontaneous brain activities in MCI-LI were distinct from MCI-no LI. The probable compensatory mechanism observed in MCI-no LI might be disrupted in MCI with LI due to vascular damage.
腔隙性脑梗死（LI）与认知功能下降及痴呆风险增加有关。轻度认知障碍（MCI）患者中，伴有和不伴有LI的患者大脑自发活动模式是否以及如何不同尚不清楚。
使用静息态功能磁共振成像（rs-fMRI）比较伴有和不伴有LI的MCI患者的大脑自发活动模式。
48例MCI患者，包括22例伴有LI的患者[MCI-LI]和26例不伴有LI的患者[MCI-无LI]，以及28名认知正常的受试者接受了rs-fMRI检查，并采用局部一致性（ReHo）和低频振幅（ALFF）方法进行后处理。
与认知正常的受试者相比，MCI-LI患者楔前叶/楔叶（Pcu/CU）和脑岛的ReHo降低；Pcu/CU和额叶的ALFF降低；颞叶的ALFF和ReHo增加。而MCI-无LI组双侧海马及海马旁回、额叶的ReHo和ALFF增加，颞叶的ALFF和ReHo降低。与MCI-无LI患者相比，MCI-LI患者额叶的ALFF降低；Pcu/CU和脑岛的ReHo降低；颞叶的ALFF和ReHo增加（p<0.05，经AlphaSim校正）。在MCI-LI患者中，蒙特利尔认知评估量表（MOCA）评分与内侧前额叶回的ALFF值呈相对较弱的相关性（r=0.432，p=0.045）（经Bonferroni校正后具有临界显著性）。
MCI-LI患者的大脑自发活动与MCI-无LI患者不同。在MCI-无LI患者中观察到的可能的代偿机制可能因血管损伤在伴有LI的MCI中被破坏。
