Lei Yu, Su Jiabin, Jiang Hanqiang, Guo Qihao, Ni Wei, Yang Heng, Gu Yuxiang, Mao Ying
Department of Neurosurgery, Huashan Hospital of Fudan University, Wulumuqi Zhong Road 12, Shanghai, 200040, China.
Department of Neurology, Huashan Hospital of Fudan University, Shanghai, 200040, China.
Brain Imaging Behav. 2017 Feb;11(1):176-184. doi: 10.1007/s11682-016-9518-5.
Aberrant local connectivity within cerebral intrinsic connectivity networks (ICNs) at rest has not been reported in adult moyamoya disease (MMD). Our aim was to examine the regional homogeneity (ReHo) of executive control (ECN), default mode (DMN), and salience networks (SN) in patients with executive dysfunction to explore the underlying mechanism. Twenty-six adult patients with MMD and 24 normal control (NC) subjects were recruited. Executive function was evaluated by Trail Making Test Part B (TMT-B) and executive subtests of Memory and Executive Screening (MES-EX). Compared with NC, the case group exhibited ReHo decrease mainly in the frontal and parietal gyrus, and increase only in the left middle temporal gyrus. Subsequent ICNs analysis indicated that compared with NC, patients with MMD exhibited significantly decreased ReHo in the dorsolateral prefrontal cortex (DLPFC) and inferior parietal gyrus (IPG) of left ECN; the IPG, superior frontal gyrus, and DLPFC of the right ECN; the right precuneus, left medial superior frontal gyrus, and right medial orbitofrontal gyrus of the DMN; as well as the left middle frontal gyrus and right supplemental motor area of SN. When referring to the Suzuki's 6-stage classification, a trend of ReHo decrease with disease severity was observed in all of the ICNs examined, but only bilateral ECNs reached statistical significance. Finally, only bilateral ECNs exhibited a significant correlation of averaged ReHo values with executive performance. Our results provide new insight into the pathophysiology of adult MMD.
静息状态下，成人烟雾病（MMD）患者脑内固有连接网络（ICN）的局部连接异常尚未见报道。我们的目的是研究执行功能障碍患者执行控制网络（ECN）、默认模式网络（DMN）和突显网络（SN）的局部一致性（ReHo），以探索其潜在机制。招募了26例成年MMD患者和24例正常对照（NC）受试者。通过数字符号试验B部分（TMT-B）和记忆与执行筛查（MES-EX）的执行子测试评估执行功能。与NC组相比，病例组主要在额回和顶叶回出现ReHo降低，仅在左侧颞中回出现ReHo升高。随后的ICN分析表明，与NC组相比，MMD患者左侧ECN的背外侧前额叶皮质（DLPFC）和顶下小叶（IPG）、右侧ECN的IPG、额上回和DLPFC、DMN的右侧楔前叶、左侧额上内侧回和右侧眶额内侧回以及SN的左侧额中回和右侧辅助运动区的ReHo显著降低。参照铃木6期分类法，在所检查的所有ICN中均观察到ReHo随疾病严重程度降低的趋势，但只有双侧ECN达到统计学意义。最后，只有双侧ECN的平均ReHo值与执行表现存在显著相关性。我们的结果为成人MMD的病理生理学提供了新的见解。
