Zhang Zhiqiang, Wu Ying, Luo Qing, Tu Junhao, Li Jiahao, Xiong Jiaxin, Lv Huiting, Ye Jing
Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Front Neurosci. 2023 Jul 27;17:1146259. doi: 10.3389/fnins.2023.1146259. eCollection 2023.
The aim of this study was to assess the brain functional changes of patients with chronic rhinosinusitis with olfactory dysfunction (CRSwOD) using regional homogeneity (ReHo) of resting-state functional magnetic resonance imaging (MRI) scans, and to better explain the occurrence and development of olfactory decline in patients with chronic sinusitis provides a new idea for the study of more advanced olfactory therapy modalities.
A total of 28 CRSwOD patients, 24 patients with CRS without olfactory dysfunction (CRSsOD), and 25 healthy controls (HCs) were recruited. All subjects underwent olfactory testing, clinical and brief psychological assessments, and MRI scans. A two-sided two-sample test with AlphaSim correction (voxel- < 0.001, cluster size >54 voxels) was used to detect differences between CRSwOD, CRSsOD, and HC groups.
Compared with HCs, the ReHo values in traditional olfactory regions (e.g., parahippocampal gyrus (PHG), hippocampal, olfactory cortex) were increased, and ReHo values in the frontal gyrus, middle temporal gyrus, precuneus, and posterior cingulate gyrus were decreased in CRSwOD patients. The ReHo values in the precuneus and posterior cingulate gyrus of CRSwOD patients were negatively correlated with Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS) scores. Compared with CRSsOD patients, the ReHo values in cerebellar regions were increased and those in the inferior temporal gyrus, precuneus, postcentral, and paracentral gyrus were decreased in CRSwOD patients. The receiver operating characteristic (ROC) curve showed that the mean ReHo values significantly differed between the CRSwOD and CRSsOD groups.
Synchronization of regional brain activity in the regions of the secondary olfactory cortex orbitofrontal cortex (OFC), temporal gyrus, precuneus, and cerebellum may be closely related to the development of olfactory dysfunction. Precuneus and posterior cingulate gyrus may be critical brain areas of action for emotional dysfunction in CRSwOD patients.
本研究旨在利用静息态功能磁共振成像（MRI）扫描的局部一致性（ReHo）评估慢性鼻窦炎伴嗅觉功能障碍（CRSwOD）患者的脑功能变化，为更好地解释慢性鼻窦炎患者嗅觉减退的发生发展提供新思路，为更先进的嗅觉治疗方式的研究提供依据。
共招募了28例CRSwOD患者、24例无嗅觉功能障碍的慢性鼻窦炎（CRSsOD）患者和25名健康对照者（HCs）。所有受试者均接受嗅觉测试、临床和简短心理评估以及MRI扫描。采用双侧双样本检验并进行AlphaSim校正（体素<0.001，聚类大小>54体素）来检测CRSwOD组、CRSsOD组和HC组之间的差异。
与HCs相比，CRSwOD患者传统嗅觉区域（如海马旁回（PHG）、海马、嗅觉皮层）的ReHo值升高，而额回、颞中回、楔前叶和后扣带回的ReHo值降低。CRSwOD患者楔前叶和后扣带回的ReHo值与嗅觉障碍问卷 - 负面陈述（QOD - NS）评分呈负相关。与CRSsOD患者相比，CRSwOD患者小脑区域的ReHo值升高，颞下回、楔前叶、中央后回和中央旁回的ReHo值降低。受试者工作特征（ROC）曲线显示，CRSwOD组和CRSsOD组的平均ReHo值存在显著差异。
次级嗅觉皮层眶额皮层（OFC）、颞回、楔前叶和小脑区域的脑区活动同步可能与嗅觉功能障碍的发生密切相关。楔前叶和后扣带回可能是CRSwOD患者情绪功能障碍的关键脑区。
