目的: 分析基于功能性磁共振成像(fMRI)和弥散张量成像(DTI)的抗富亮氨酸胶质失活蛋白1(LGI1)抗体自身免疫性脑炎的脑功能和结构特点,为理解抗LGI1抗体自身免疫性脑炎的神经病理机制提供思路。方法: 选取2019年8月至2022年7月我院收治的25例抗LGI1抗体自身免疫性脑炎患者作为研究组,选取同期招募的25例无脑部疾病志愿者作为对照组。50例研究对象分别接受量表评估、fMRI和DTI检查,基于fMRI检查进行局部一致性(ReHo)分析,基于DTI检查结果对脑白质纤维结构进行分析。结果:研究组的改良Rankin量表(mRS)评分显著性高于对照组(P＜0.05),简易精神状态检查量表(MMES)、蒙特利尔认知评估量表(MoCA)评分显著性低于对照组(P＜0.05)。研究组受试者中,其右侧颞上回、右侧颞中回以及左侧尾状核的ReHo相比于对照组受试者出现了显著的降低变化(P＜0.05)。在研究组受试者中,其前放射冠、上放射冠、后放射冠、内囊前肢、内囊的晶状体后部分、丘脑后辐射、外囊、上纵束、胼胝体压部、胼胝体体部、胼胝体膝部的向异性分数(FA)和平均弥散率(MD)相比于对照组受试者分别出现显著降低、显著升高的变化(P＜0.05)。结论: 抗LGI1抗体自身免疫性脑炎患者可出现记忆功能、认知功能、运动功能衰退的现象,与大脑存在广泛的脑白质纤维病变有关。 |
Objective: To investigate the brain function and structural characteristics of anti-leucine-rich glial inactivating protein 1(LGI1) antibody autoimmune encephalitis based on functional magnetic resonance imaging(fMRI) and diffusion tensor imaging(DTI), in order to provide ideas for understanding the neuropathological mechanism of anti-LGI1 antibody autoimmune encephalitis. Methods: Twenty-five patients with anti-LGI1 antibody autoimmune encephalitis admitted to our hospital from August 2019 to July 2022 were selected as the research group, and 25 volunteers without brain disease recruited during the same period were selected as the control group. Fifty subjects were evaluated by scale, fMRI and DTI respectively. Reagional homogeneity(ReHo) analysis was performed based on fMRI examination, and white matter fiber structure was analyzed based on DTI examination results. Results: The score of Modified Rankin Scale(mRS) in the study group was significantly higher than that in the control group(P<0.05). The scores of the Mini-Mental State Examination(MMES) and Montreal Cognitive Assessment(MoCA) in the study group were significantly lower than those in the control group(P<0.05).The ReHo of the right superior temporal gyrus, right middle temporal gyrus and left caudate nucleus of the subjects in the study group were significantly lower than those in the control group(P<0.05). The fractional anisotropy(FA) of the anterior radial crown, the upper radial crown, the posterior radial crown, the anterior limb of the inner capsule, the posterior part of the lens of the inner capsule, the posterior part of the thalamus, the outer capsule, the upper longitudinal bundle, the compression part of the corpus callosum, the corpus callosum, and the knee of the corpus callosum in the study group were lower than those in the control group, and the mean diffusivity(MD) of these parts were higher than those in the control group(P<0.05). Conclusion: Patients with anti-LGI1 antibody autoimmune encephalitis may experience the decline of memory function, cognitive function and motor function in brain function, which is related to the existence of extensive white matter fibrosis in the brain. |
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