Bao Haihua, He Xin, Wang Fangfang, Kang Dongjie
Department of Medical Imaging Center, Qinghai University Affiliated Hospital, Xining, China.
Front Neurol. 2022 Jan 7;12:763835. doi: 10.3389/fneur.2021.763835. eCollection 2021.
Headache and memory impairment are the primary clinical symptoms of chronic mountain sickness (CMS). In this study, we used voxel-based morphometry (VBM) and the amplitude of the low-frequency fluctuation method (ALFF) based on blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) to identify changes in the brain structure and function caused by CMS. T1W anatomical images and a resting-state functional MRI (fMRI) of the whole brain were performed in 24 patients diagnosed with CMS and 25 normal controls matched for age, sex, years of education, and living altitude. MRI images were acquired, followed by VBM and ALFF data analyses. Compared with the control group, the CMS group had increased gray matter volume in the left cerebellum crus II area, left inferior temporal gyrus, right middle temporal gyrus, right insula, right caudate nucleus, and bilateral lentiform nucleus along with decreased gray matter volume in the left middle occipital gyrus and left middle temporal gyrus. White matter was decreased in the bilateral middle temporal gyrus and increased in the right Heschl's gyrus. Resting-state fMRI in patients with CMS showed increased spontaneous brain activity in the left supramarginal gyrus, left parahippocampal gyrus, and left middle temporal gyrus along with decreased spontaneous brain activity in the right cerebellum crus I area and right supplementary motor area. Patients with CMS had differences in gray and white matter volume and abnormal spontaneous brain activity in multiple brain regions compared to the controls. This suggests that long-term chronic hypoxia may induce changes in brain structure and function, resulting in CMS.
头痛和记忆障碍是慢性高原病（CMS）的主要临床症状。在本研究中，我们基于血氧水平依赖性功能磁共振成像（BOLD-fMRI），采用基于体素的形态学测量（VBM）和低频波动幅度法（ALFF）来识别由CMS引起的脑结构和功能变化。对24例诊断为CMS的患者和25例年龄、性别、受教育年限及居住海拔相匹配的正常对照者进行了全脑T1加权解剖图像和静息态功能磁共振成像（fMRI）检查。采集MRI图像，随后进行VBM和ALFF数据分析。与对照组相比，CMS组左侧小脑Ⅱ脚区、左侧颞下回、右侧颞中回、右侧岛叶、右侧尾状核及双侧豆状核的灰质体积增加，而左侧枕中回和左侧颞中回的灰质体积减少。双侧颞中回的白质减少，右侧颞横回的白质增加。CMS患者的静息态fMRI显示，左侧缘上回、左侧海马旁回和左侧颞中回的自发脑活动增加，而右侧小脑Ⅰ脚区和右侧辅助运动区的自发脑活动减少。与对照组相比，CMS患者在多个脑区的灰质和白质体积存在差异，且自发脑活动异常。这表明长期慢性缺氧可能诱发脑结构和功能的变化，从而导致CMS。
