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原发性开角型青光眼V1区皮层功能变化的功能MRI研究
  • 期刊名称:中华放射学杂志
  • 时间:0
  • 页码:613-617
  • 语言:中文
  • 分类:R775.2[医药卫生—眼科;医药卫生—临床医学]
  • 作者机构:[1]第三军医大学西南医院放射科,重庆400038, [2]第三军医大学西南医院眼科,重庆400038, [3]解放军第四二医院放射科, [4]武警湖北省总队医院放射科, [5]第三军医大学大坪医院眼科
  • 相关基金:国家自然科学基金资助项目(30870697)
  • 相关项目:基于功能磁共振的原发性开角型青光眼视觉通路功能形态改变及视皮层功能重组的研究
中文摘要:

目的利用fMRI视网膜皮层映射技术研究原发性开角型青光眼(POAG)患者V1区皮层功能变化。方法选取15例POAG患者及15名正常志愿者,利用视网膜皮层映射分区刺激和圆形黑白翻转棋盘格刺激采集fMRI数据。采用配对样本t检验比较POAG患者患侧眼与健侧眼V1区的fMRI反应、独立样本t检验比较健侧眼与匹配的正常人眼V1区的fMRI反应和激活。POAG患者患侧眼和健侧眼单独刺激时的V1皮层功能差异与视功能差异做线性相关分析。结果(1)患侧眼接受刺激时V1区fMRI反应较健侧眼弱(t=4.757,P〈0.01),患侧眼和健侧眼fMRI反应分别为(1.244-0.72)%、(2.18±0.93)%。患侧眼、健侧眼分别与其年龄、性别、眼侧别相匹配的正常人眼V1区fMRI反应进行比较:患侧眼较正常人眼反应弱(t=-3.011,P〈0.01),患侧眼和匹配眼fMRI反应分别为(1.24±0.72)%、(2.01±0.65)%;健侧眼和匹配眼反应差异无统计学意义(t=0.742,P〉0.05),健侧眼和匹配眼分别为(2.18±0.93)%、(1.95±0.75)%。(2)患侧眼与健侧眼单独刺激的V1皮层功能差异与视功能差异存在线性负相关(r=-0.887,P〈0.01)。(3)患者的健侧眼与其年龄、性别、眼侧别相匹配的正常人眼比较,患者健侧眼V1激活较正常人眼小(t=-3.801,P〈0.01),健侧眼和匹配眼V1激活面积指数分别为0.72±0.12、0.85±0.09。结论青光眼存在皮层功能损害,而且青光眼皮层功能的损害与视觉功能的损害存在相关一致性;基于fMRI视网膜皮层映射分区的定位、定量测量是一种对青光眼视觉皮层功能变化临床随访、评估测量的有用方法,也是活体人青光眼视觉通路跨突触退变研究的潜在有用工具。

英文摘要:

Objective To evaluate the functional changes of visual cortex (V1) in patients with primary open angle glaucoma (POAG) by fMRI retinotopic mapping technology. Methods Fifteen POAG patients and 15 healthy volunteers underwent stimulations with fMRI retinotopic mapping stimulus and contrast-reversing checkerboard patterns stimulus on a Siemens Trio 3.0 T MRI whole-body scanner for functional data collection. Comparisons of V1 fMRI responses between the glaucomatous eyes and the healthy eyes of the patients were carried out using paired samples t-test, while independent samples t-test was used to compare V1 fMRI responses and activations between the healthy eyes of patients and the age-, gender- and sidematched eyes of normal people. Differences of V1 cortical functions and visual functions were analyzed by linear correlation analysis when the glaucomatous and the healthy eyes were simulated individually. Results ( 1 ) V1 fMRI responses of the individually stinmlated glaucomatous eyes [ ( 1.24 ± 0. 72 ) % ] were weaker than those of the healthy eyes [ (2. 18 ±0. 93) % 1 (t =4. 757,P 〈0.01). Comparisons of V1 fMRI responses between the glaueomatous eyes and matched eyes of normal people, as well as between the healthy eyes of patients and the matched eyes of normal people, were performed respectively : the responses in the glaueomatous eyes [ ( 1.24 ±0.72) % ] were weaker than those in the matched eyes of normal people [ ( 2. 01 ± 0. 65 ) % ] ( t = - 3.011 ,P 〈 0. 01 ). There was no statistical difference of the responses between the healthy eyes from patients [(2. 18 ± 0. 93 )% ] and the matched eyes of normal people[( 1.95 ± 0. 75 ) % ] ( t = 0. 742,P 〉 0.05 ). (2) Differences of V 1 cortical functions were negatively correlated with those of visual functions in the individually stimulated glaueomatous and healthy eyes ( r = - 0. 887, P 〈 0. 01 ). (3) The activated area indexes of V1 cortexes in the healthy eyes from patients (0. 72 ± 0.

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