Reduced Regional Gray Matter Volume in Patients with Chronic Obstructive Pulmonary Disease: A Voxel-Based Morphometry Study
Reduced Regional Gray Matter Volume in Patients with Chronic Obstructive Pulmonary Disease: A Voxel-Based Morphometry Study
复制标题
慢性阻塞性肺疾病患者区域灰质体积减少：基于体素的形态测量研究
DOI：
10.3174/ajnr.a3235
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发表时间：
2013-02-01
影响因子：
3.5
通讯作者：
Zhang, J.
中科院分区：
文献类型：
--
作者：
Zhang, H.;Wang, X.;Zhang, J.
背景与目的：COPD患者氧供减少可导致脑神经元损伤，主要表现为神经心理障碍、情绪障碍等临床症状。本研究旨在探讨慢性阻塞性肺疾病患者脑灰质的变化。材料和方法：采用基于体素的形态计量学方法，对25例稳定期COPD患者和25例匹配的健康志愿者进行了Gm体积高分辨率3DT1加权磁共振成像。还进行了一系列神经心理测试。结果：COPD患者额叶皮质(双侧直回、双侧眶下三角回、左侧内侧上回)、右侧前岛、扣带回(左侧前中回、右侧中间回)、右侧丘脑/枕、右侧尾状核、右侧壳核、右侧副海马区和左侧杏仁核的GM体积较对照组明显减少。在COPD患者中，局部GM体积与动脉血氧分压呈正相关，而在某些区域，局部GM体积与病程呈负相关。COPD患者(与对照组相比)在简易智力状态检查、视觉再现和图形记忆测试中表现较差。COPD患者额叶下三角区的GM体积与图形记忆评分呈显著正相关。结论：我们的发现提示COPD患者许多脑区GM减少，这与疾病的严重程度相关，可能是COPD患者病理生理和心理变化的基础。
BACKGROUND AND PURPOSE: Decreased oxygen supply may cause neuronal damage in the brains of patients with COPD, which is manifested by clinical symptoms such as neuropsychological deficits and mood disorders. The aim of the present study was to investigate brain gray matter change in COPD. MATERIALS AND METHODS: Using voxel-based morphometry based on the high-resolution 3D T1-weighted MR images of GM volume, we investigated 25 stable patients with COPD and 25 matching healthy volunteers. A battery of neuropsychological tests was also performed. RESULTS: Patients with COPD (versus controls) showed reduced GM volume in the frontal cortex (bilateral gyrus rectus, bilateral orbital and inferior triangular gyri, and left medial superior gyrus), right anterior insula, cingulate cortex (left anterior and middle gyri, right middle gyrus), right thalamus/pulvinar, right caudate, right putamen, right parahippocampus, and left amygdala. In COPD, in some of these regions, regional GM volume had positive correlations with arterial blood po2, while in some regions, regional GM volume had negative correlations with disease duration. Patients with COPD (versus controls) had poorer performance in the Mini-Mental State Examination, Visual Reproduction, and Figure Memory tests. Moreover, the GM volume in the inferior triangular frontal cortex in patients with COPD was significantly correlated with the Picture Memory score. CONCLUSIONS: Our findings suggest GM reductions in a number of brain regions in COPD, which were associated with disease severity and may underlie the pathophysiologic and psychological changes in patients with COPD.