ABSTRACT
Objective To investigate regional activity abnormalities of patients with liver cirrhosis before and after liver transplantation using resting-state fMRI and amplitude of low frequency fluctuations (ALFF)method.Methods Totally 11 patients preparing to accept liver transplantation were adopted into liver cirrhosis group and 11 healthy volunteers in the health examination were adopted into the control group. The liver cirrhosis group was investigated at a week before operation and repeatedly a month after liver trans-plantation.Healthy volunteers were investigated at the same time.MR imaging data were obtained from a Phil-ips Achieva 1.5-T MR imager.The imaging data were mainly preprocessed with a MATLAB toolbox called DPARSF.REST software was used to calculate the ALFF value of each subject.A second-level random-effect two-sample t-test was performed on the individual ALFF.Significant differences were set at the standard of a corrected cluster level of P<0.05,and software Xjview 8.1 was adopted to express the outcome.Results (1)Compared with control group,decreased ALFF were found in bilateral middle occipital gyrus(MOG) (MNI:x=36,y=-72,z=9),bilateral precuneus/cuneus(PCu/Cu)/posterior cingulated(PCC)(MNI:x=15,y=-66,z=24),left inferior parietal lobule(LIPL)(MNI:x=-39,y=-54,z=42),and bilateral para-central lobule/cingulate gyrus(MNI:x=3,y=-36,z=45)of cirrhosis patients,no increased ALFF were found.(2)Compared with cirrhosis patients,no increased or decreased ALFF were found in postoperative group.After relaxing standards of statistics,increased ALFF were found in left inferior parietal lobule(IPL) (MNI:x=-39,y=-51,z=42),cingulate gyrus(MNI:x=3,y=-33,z=42),and right middle frontal gyrus (MNI:x=35,y=57,z=0)of postoperative group,no decreased ALFF were found.(3)Compared with control group,decreased ALFF were found in bilateral precuneus/posterior cingulated(PCC),and left middle occipi-tal gyrus(MOG)of postoperative group,no increased ALFF were found.Conclusions Significant decreased ALFF is found in visual cortex(PCu),DMN((PCu/Cu/PCC),and LIPL of cirrrhosis patients,and those ab-normalities reflect the weakness of local neurons spontaneous low-frequency.Compared with beforeoperative group,ALFF of LIPL,in cingulate gyrus,and right middle frontal gyrus have a tendency of rising.One month after liver transplantation,decreased ALFF is found in BA7 and BA 31,suggesting that the spontaneous low-frequency of local neurons haven't recoverd to normal level.
ABSTRACT
Objective To explore the effects of modified balloon dilatation therapy for treating upper esophageal sphincter dysfunction after a brainstem stroke.Methods Ten healthy adult volunteers and 20 dysphagic patients with upper esophageal sphincter dysfunction after a brainstem stroke were recruited.The 20 patients were divided into a balloon dilatation therapy group of ten who were treated with catheter balloon dilatation therapy, and a control group of ten who received conventional therapy.All were given block-designed task fMRI scans guided by a matched visual presentation system before and after the treatment.Results Widespread activation was observed in both hemispheres, including the bilateral cerebral cortex, the brainstem and the cerebellum, but the activated areas were significantly smaller in the stroke patients before treatment.After the treatment, seven patients in the balloon dilatation group were totally orally fed, while only three patients in the control group recovered totally oral intake.After dilatation, significantly more regions were activated, including the anterior cingulate, insula, supplementary motor area, precuneus and the frontal lobe.They were activated with relatively low voxels in the treatment group, while in the control group significant activation was observed only in the precuneus after treatment.Conclusion Modified balloon dilatation therapy can increase activation of the cortex and subcortical structures related to swallowing, promoting better swallowing function.