背景:神经元活动与血液灌注之间的耦合称为神经血管耦合(NVC),它提供了一个潜在的新的机械视角来理解许多脑部疾病。尽管在线粒体肌病中已经分别报道了异常的脑活动和血液供应,脑病,乳酸性酸中毒,和中风样发作(MELAS),是否存在异常NVC尚不清楚.
目的:通过结合静息态功能MRI(rs-fMRI)和动脉自旋标记(ASL)研究MELAS的NVC变化和潜在的神经基础。
方法:前瞻性。
方法:急性期24例MELAS患者(年龄:29.8±7.3岁)和24例健康对照(HCs,年龄:26.4±8.1岁)。此外,随访慢性期患者12例。
■3.0T,静息状态梯度召回回波平面成像和伪连续3DASL序列。
结果:低频波动幅度(ALFF),分数ALFF(fALFF),区域同质性(ReHo),功能连接强度(FCS)由rs-fMRI计算,根据ASL计算脑血流量(CBF)。通过CBF-ALFF的相关系数评估全球NVC,CBF-fALFF,CBF-ReHo,和CBF-FCS。还通过CBF/ALFF的逐体素和逐病变比率评估了区域NVC,CBF/fALFF,CBF/ReHo,和CBF/FCS。
方法:双样本t检验,配对样本t检验,高斯随机场校正。P值<0.05被认为是统计学上显著的。
结果:与HC相比,MELAS患者急性期显示全球CBF-ALFF显著降低,CBF-fALFF,CBF-ReHo,和CBF-FCS偶联(P<0.001)。改变CBF/ALFF,CBF/fALFF,CBF/ReHo,CBF/FCS比值主要分布在MELAS患者的大脑中动脉区域。此外,在急性期的急性卒中样病变中发现NVC比率显着增加(P<0.001),慢性阶段有恢复趋势。
结论:本研究显示MELAS患者从急性到慢性阶段NVC的动态改变,这可能为理解MELAS的发病机制提供新的见解。
方法:2技术效果:第一阶段。
BACKGROUND: Coupling between neuronal activity and blood perfusion is termed neurovascular coupling (NVC), and it provides a potentially new mechanistic perspective into understanding numerous brain diseases. Although abnormal brain activity and blood supply have been separately reported in mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), whether anomalous NVC would be present is unclear.
OBJECTIVE: To investigate NVC changes and potential neural basis in MELAS by combining resting-state functional MRI (rs-fMRI) and arterial spin labeling (ASL).
METHODS: Prospective.
METHODS: Twenty-four patients with MELAS (age: 29.8 ± 7.3 years) in the acute stage and 24 healthy controls (HCs, age: 26.4 ± 8.1 years). Additionally, 12 patients in the chronic stage were followed up.
UNASSIGNED: 3.0 T, resting-state gradient-recalled echo-planar imaging and pseudo-continuous 3D ASL sequences.
RESULTS: Amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), regional homogeneity (ReHo), and functional connectivity strength (FCS) were calculated from rs-fMRI, and cerebral blood flow (CBF) was computed from ASL. Global NVC was assessed by correlation coefficients of CBF-ALFF, CBF-fALFF, CBF-ReHo, and CBF-FCS. Regional NVC was also evaluated by voxel-wise and lesion-wise ratios of CBF/ALFF, CBF/fALFF, CBF/ReHo, and CBF/FCS.
METHODS: Two-sample t-test, paired-sample t-test, Gaussian random fields correction. A P value <0.05 was considered statistically significant.
RESULTS: Compared with HC, MELAS patients in acute stage showed significantly reduced global CBF-ALFF, CBF-fALFF, CBF-ReHo, and CBF-FCS coupling (P < 0.001). Altered CBF/ALFF, CBF/fALFF, CBF/ReHo, and CBF/FCS ratios were found mainly distributed in the middle cerebral artery territory in MELAS patients. In addition, significantly increased NVC ratios were found in the acute stroke-like lesions in acute stage (P < 0.001), with a recovery trend in chronic stage.
CONCLUSIONS: This
study showed dynamic alterations in NVC in MELAS patients from acute to chronic stage, which may provide a novel insight for understanding the pathogenesis of MELAS.
METHODS: 2 TECHNICAL EFFICACY: Stage 1.