Reversible alterations of the neuronal activity in spontaneous intracranial hypotension
Reversible alterations of the neuronal activity in spontaneous intracranial hypotension
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DOI：
10.1177/0333102415585085
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发表时间：
2016-02-01
期刊：
影响因子：
4.9
通讯作者：
Ohtomo, Kuni
中科院分区：
文献类型：
--
作者：
Amemiya, Shiori;Takahashi, Koichi;Ohtomo, Kuni
目的探讨自发性低颅压（SIH）患者认知功能和神经元活动改变的病理生理机制。方法对15例SIH患者分别于术前1 d和术后1个月进行静息态功能磁共振成像（fMRI）和工作记忆（WM）检查。认知功能和自发神经元活动的变化测量的低频波动（ALFF）的幅度和默认模式网络（DMN）和额顶网络（FPNs）的功能连接进行了评估。ALFF的全脑线性回归分析显示，在楔前叶的ALFF变化与认知性能的变化呈正相关，而在双侧眶额皮质（OFCs）和右内侧额叶皮质（MFC）的负相关。ALFF变化随术后WM性能改善而正常化。术前右侧眶额肌的FPN活性也增加。偏相关分析显示，WM性能和控制右FPN activity.Conclusions的OFCs和MFC的活动，这不是起源于同步的内在网络活动的异常活动，连同DMN的中央节点的活动减少，可能会导致认知功能障碍的SIH是可逆的，通过脑脊液的恢复。
Aim The aim of this article is to investigate the pathophysiology underlying the alternation of the cognitive function and neuronal activity in spontaneous intracranial hypotension (SIH).Methods Fifteen patients with SIH underwent resting-state functional magnetic resonance imaging and working-memory (WM) test one day before and one month after a surgical operation. Alternation of the cognitive function and spontaneous neuronal activity measured as amplitude of the low-frequency fluctuations (ALFF) and the functional connectivity of the default-mode network (DMN) and frontoparietal networks (FPNs) were evaluated.Results WM performance significantly improved post-operatively. Whole-brain linear regression analysis of the ALFF revealed a positive correlation between cognitive performance change and ALFF change in the precuneus while a negative correlation was found in the bilateral orbitofrontal cortices (OFCs) and right medial frontal cortex (MFC). The ALFF changes normalised with the WM performance improvement post-operatively. The FPN activity in the right OFC was also increased pre-operatively. Partial correlation analysis revealed a significant correlation between WM performance and right OFC activity controlled for right FPN activity.Conclusions The abnormal activity of the OFCs and MFC that is not originating from the synchronous intrinsic network activity, together with the decreased activity of the central node of the DMN, could lead to cognitive impairment in SIH that is reversible through restoration of the cerebrospinal fluid.