Lu Li, Wang Junpeng, Zhang Longjiang, Zhang Zhiqiang, Ni Ling, Qi Rongfeng, Kong Xiang, Lu Mengjie, Sami Muhammad U, Xu Kai, Lu Guangming
Department of Medical Imaging, Jinling Clinical Medical College of Nanjing Medical University.
The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Neuroreport. 2018 Aug 15;29(12):993-1000. doi: 10.1097/WNR.0000000000001063.
The association between metabolic activity and functional coupling of the posterior cingulate cortex (PCC) in cirrhotic patients remains undefined. Therefore, this study aimed to assess the association of functional coupling with metabolic patterns of PCC in resting cirrhotic patients. Twenty-six cirrhotic patients, including 10 with hepatic encephalopathy (HE) and 16 without HE, were assessed, alongside 21 control participants. Single-voxel proton magnetic resonance spectroscopy (MRS) of the PCC and resting-state functional MRI (rs-fMRI) were performed on a 3.0-T MR scanner. The ratios of all metabolites to creatine (Cr) and rs-fMRI parameters [including amplitude of low-frequency fluctuation (ALFF), node degree (Ki), and betweenness centrality (Bi)] were evaluated by analysis of variance. Associations of metabolite ratios with rs-fMRI parameters and venous ammonia were determined by Pearson's correlation analysis. Lower chlorine (Cho)/Cr (0.6±0.2 vs. 0.9±0.1, P<0.001) and higher ALFF (1.3±0.5 vs. 1.1±0.3, P=0.01) were found in cirrhotic patients in comparison with controls. In cirrhotic patients, the ALFF values correlated negatively with Cho/Cr (r=-0.397, P=0.044). Meanwhile, Bi values showed positive associations with glutamine+glutamate/Cr (r=0.500, P=0.009) and N-acetyl aspartate/Cr (r=0.581, P=0.006). In the HE subgroup, Ki correlated positively with Cho/Cr (r=0.867, P=0.001). In cirrhotic patients without HE, Bi values showed a high positive correlation with glutamate+glutamine/Cr (r=0.690, P=0.013). These findings suggest a close association between metabolic activity and functional coupling of the PCC in cirrhotic patients, especially those with HE, whose node degree of the PCC shows an overt positive correlation with Cho/Cr.
肝硬化患者后扣带回皮质（PCC）的代谢活性与功能耦合之间的关联尚不清楚。因此，本研究旨在评估静息状态下肝硬化患者PCC的功能耦合与代谢模式之间的关联。对26例肝硬化患者（包括10例肝性脑病患者和16例无肝性脑病患者）以及21名对照参与者进行了评估。在3.0-T磁共振成像仪上对PCC进行单体素质子磁共振波谱分析（MRS）和静息态功能磁共振成像（rs-fMRI）。通过方差分析评估所有代谢物与肌酸（Cr）的比率以及rs-fMRI参数[包括低频波动幅度（ALFF）、节点度（Ki）和中介中心性（Bi）]。通过Pearson相关分析确定代谢物比率与rs-fMRI参数及静脉血氨之间的关联。与对照组相比，肝硬化患者的胆碱（Cho）/Cr较低（0.6±0.2对0.9±0.1，P<0.001），ALFF较高（1.3±0.5对1.1±0.3，P=0.01）。在肝硬化患者中，ALFF值与Cho/Cr呈负相关（r=-0.397，P=0.044）。同时，Bi值与谷氨酰胺+谷氨酸/Cr呈正相关（r=0.500，P=0.009），与N-乙酰天门冬氨酸/Cr呈正相关（r=0.581，P=0.006）。在肝性脑病亚组中，Ki与Cho/Cr呈正相关（r=0.867，P=0.001）。在无肝性脑病的肝硬化患者中，Bi值与谷氨酸+谷氨酰胺/Cr呈高度正相关（r=0.690，P=0.013）。这些发现表明肝硬化患者，尤其是肝性脑病患者，PCC的代谢活性与功能耦合之间存在密切关联，其PCC的节点度与Cho/Cr呈明显正相关。
