Abnormal regional homogeneity of resting-state brain activity in patients with HBV-related cirrhosis without overt hepatic encephalopathy
Abnormal regional homogeneity of resting-state brain activity in patients with HBV-related cirrhosis without overt hepatic encephalopathy
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DOI：
10.1111/liv.12096
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发表时间：
2013-03-01
影响因子：
6.7
通讯作者：
Zhang, Xue-Lin
中科院分区：
文献类型：
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作者：
Lv, Xiao-Fei;Qiu, Ying-Wei;Zhang, Xue-Lin
背景许多研究报道，无明显肝性脑病（OHE）的肝硬化患者存在认知功能障碍。然而，这些缺陷背后的神经生物学机制仍然没有完全理解。目的应用静息态功能磁共振成像（Rs-fMRI）研究无肝外出血（OHE）的B病毒相关肝硬化（HBV-RC）患者脑局部活动异常，探讨其与认知功能损害的关系。方法采用最新报道的区域均匀性（ReHo）方法，比较32例无OHE的HBV-RC患者和32例匹配的健康对照者的Rs-fMRI信号局部同步性。采用心理测量学肝性脑病评分（PHES）测试对所有患者的认知功能进行测量，并分析ReHo变异与PHES之间的关系。结果与健康对照组相比，肝硬化组前额叶ReHo明显增高，视觉关联区（左侧舌回、颞中回和右侧枕中回）、运动关联区（双侧中央前回和中央旁小叶）和双侧楔前叶ReHo普遍降低。相关分析显示，癫痫患者不同脑区ReHo值与PHES呈显著正相关，其中左侧舌回（r=0.352，P=0.048）、右侧枕中回（r=0.453，P=0.009）和双侧中央前回（左侧：r=0.436，P=0.013;右侧：r=0.582，P= 0.005）与PHES呈显著正相关。
Background Many studies have reported that cognitive deficits exist in cirrhotic patients without overt hepatic encephalopathy (OHE). However, the neurobiological mechanisms underlying these deficits are still not fully understood. Aim To investigate regional activity abnormalities in patients with hepatitis B virus-related cirrhosis (HBV-RC) without OHE using resting-state functional MRI (Rs-fMRI), and to examine the relationship between regional activity abnormalities and impaired cognition. Methods A newly reported regional homogeneity (ReHo) approach was used to compare the local synchronization of Rs-fMRI signals in 32 patients with HBV-RC without OHE and 32 well-matched healthy controls. Cognition was measured in all patients using psychometric hepatic encephalopathy score (PHES) tests, and the relationship between ReHo variation and PHES was analysed. Results Relative to healthy controls, the cirrhosis group showed high ReHo in the prefrontal cortex, and widespread low ReHo in visual association areas (left lingual gyrus, middle temporal gyrus and right middle occipital gyrus), motor association areas (bilateral precentral gyrus and paracentral lobule) and the bilateral precuneus. Correlation analysis of the mean ReHo values in different brain areas and PHES in cirrhotic patients revealed a significantly positive correlation in the left lingual gyrus (r=0.352; P=0.048), right middle occipital gyrus (r=0.453; P=0.009) and bilateral precentral gyrus (left: r=0.436, P=0.013; right: r=0.582, P