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Objective To explore the changes of brain functional network in insomnia disorder (ID) during resting-state with voxel-based degree centrality (DC).Methods Forty-five subjects underwent resting-state fMRI scans,including 22 patients with ID (ID group) and 23 sex-,age-,and education-matched healthy volunteers (control group).The subjects' sleep quality and emotion state were assessed with Pittsburgh sleep quality index (PSQI),Hamilton anxiety scale and Hamilton depression scale.The resting-state fMRI data were analyzed with voxel-based DC.The intra-and inter-groups parameters were compared using t-test.Correlation analysis was performed between DC values of ID group and clinical parameters.Results Compared with control group,DC values increased in left parahippocampal gyrus,left hippocampus and bilateral precuneus (all P＜0.05),while decreased in left middle occipital lobe,left precuneus,left inferior frontal gyrus and left middle frontal gyrus in ID group (all P＜0.05).DC values of the left hippocampus in ID patients showed significantly negative correlation with the score of Pittsburgh sleep quality index (r=-0.46,P=0.047).Conclusion ID patients have abnormal DC distribution of brain functional network,therefore providing basis for understanding pathophysiological mechanisms of ID.
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Objective To explore the effect of measure accuracy of crevasse diameter of atrial septal defect (ASD) by transthoracic echocardiography (TTE) on radiation dose during interventional therapy.Methods 79 cases ASD with interventional therapy in our hospital were analyzed retrospectively,according to the times which we chosen occluder device on the basis of defect diameter by TTE,we divided those cases into three groups:group A,the occluder device chosen well,and it took only one time to block success (50 cases);group B,it took two times to block success (22 cases);group C,because of the measurement error,it needed three times to block success (7 cases).Following data were separately recorded:①measurement values of TTE,size of the occluder device and times of occluder device exchange;② radiation dose [cumulative radiation dose (AK,Gy),area dose product (DAP,Gy · cm2),fluoroscopic time (T,min)];③patient gender,age and body mass.Results All the cases were blocked success,the coincidence rate of TTE and occluder device were 62.67 ％,28 ％,9.33 ％,but there were significantly differences of AK,DAP and T in three groups (FAK=12.119,P=0.000;FDAp=8.241,P=0.001;FT =12.777,P=0.000).It showed that the radiation dose and T of group C were the largest and the longest,and group A were the least and the shortest,while the radiation dose and T of group B ranged between A and C groups.There was no statistically difference between radiation dose for different gender,age,body mass(P≥0.050).Conclusion The times of block and radiation dose is most influenced by the coincidence rate of TTE and occluder device.Increase of the coincidence rate may decrease the times of block and reduce the radiation dose for surgeon and patient.
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Objective To investigate radiation dose diffent type of anesthesia affected radiation dose when we do interventional therapy for child patent ductus arteriosus (PDA).Methods From 201 1 to 2014,we collected 50 children(3-6 years old)with PDA which received interventional therapy were included in the study.They were divided into two groups:group A (25 cases,male/fe-male=7/18,mean weight=1 5.32 kg±2.41 5 kg)underwent interventional therapy of PDA under general anesthesia,and group B (25 cases,male/female=13/12,mean weight=1 6.40 kg±2.056 kg)using local anesthesia.The surgery were operated by the same doctor,we used DSA children cardiovascular film AE mode (ped CARD)to monitor the surgery,image frames 1 5-30 f/s,used the non-ionic contrast agent (Iodixanol 320 mg I/mL)and recorded the child cumulative incidence of skin surface dose (AK),dose area product(DAP),and time of fluoroscopy,and do statistical analysis.Results All 50 cases were performed the surgery successfully. There were no significant difference of age,weight and gender between groups (age:t=1.924,P =0.06;weight:t =1.703,P =0.095;gender:χ2 =3.00,P =0.083).The cumulative incidence of skin surface dose (AK),dose area product (DAP)and time of fluoroscopy were (0.061±0.025)Gy,(5.08±2.19)Gy·cm2 and (3.15±1.16)min in A group,and (0.094±0.046)Gy,(8.41±3.587)Gy·cm2 , (6.86±3.27)min in B group.The sequence and image number of two groups were same.There were significantly differences of cumulative incidence of skin surface dose (AK),dose area product (DAP)and time of fluoroscopy between two groups (AK:t =3.152,P =0.003;DAP:t =3.957,P =0.000;time of fluoroscopy:t =5.346,P =0.000).The radiation doses of A group significantly lower than B group,compared with B group,the radiation dose were 40 percent [(1-5.08/8.41)%]lower in A group,the 1.1 7 times discrepancy of time of fluoroscopy between two group [(3.1 5-6.86)/3.1 5].Conclusion Radiation dose is associated with type of anesthesia. Compared with local anesthesia,radiation dose reduced 40% using general anesthesia during interventional therapy for PDA.
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Purpose The study aimed to explore gender differences of brain activation in healthy volunteers under the stimulation of emotional pictures.Materials and Methods The cerebral functional imaging data of twenty healthy volunteers at Henan Medical College from Nov.2014 to Dec.2014 were prospectively studied (12 males and 8 females).Emotional pictures (30 positive,30 negative and 30 neutral pictures) from Chinese Affective Picture System (CAPS) were used randomly as visual stimuli for both males and females.Functional MRI was performed while each subject was stimulated by emotional pictures.The fMRI data were processed and the statistical analysis was performed to obtain the activated brain regions of males and females and to compare the gender differences.Results Under the stimuli of negative emotional pictures,bilateral temporal lobe,bilateral cuneus in men and bilateral cuneus in women were activated under the stimuli of positive emotional pictures (P＜0.05).Compared with men,increased activation of left amygdala,bilateral prefrontal gyrus,bilateral precuneus and right insula were observed in women under the stimuli of negative pictures.The differences were statistically significant (P＜0.05).Compared with women,no cerebral region was more activated in men under the stimuli of negative pictures.Under the stimuli of positive emotional pictures,the left prefrontal gyrus in women was more activated than that in men whilst the left temporal lobe in men was more activated than that in women.The differences were statistically significant (P＜0.05).Conclusion Gender differences of activated cerebral regions under stimuli of emotional pictures do exist in healthy volunteers.In particular,more cerebral regions and increased activation were observed in women compare to men,which demonstrates that women response stronger to negative emotion.
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Objective To observe the alterations in brain gray matter volume(GMV)in idiopathic generalized epilepsy(IGE)patients with typical absence seizure. Methods Nine IGE patients with typical absence seizure and 16 healthy volunteers were prospectively recruited from People's Hospital of Zhengzhou University from September 2012 to January 2014. By using a 3. 0T magnetic resonance imaging(MRI)and voxel - based morphometry(VBM)method, their whole brain structures and their brain GMV were scanned and analyzed,respectively,then the changes in GMV were observed. Results Compared with healthy control group,brain GMV extensively decreased in IGE patients with typical absence seizure. Thirteen regions with significant differences were as follows:the right rectal gyrus(t = 3. 13,P ﹤0. 01),the left rectal gyrus(t = 4. 82,P ﹤ 0. 01),the right calcarine/ cuneus/ gyrus lingualis/ occipital gyrus/ inferior oc-cipital gyrus(t = 6. 86,P ﹤ 0. 01),right gyrus lingualis(t = 4. 01,P ﹤ 0. 01),the left gyrus lingualis/ inferior occipital gyrus(t = 3. 73,P ﹤ 0. 01),the left inferior occipital gyrus/ gyrus lingualis(t = 5. 42,P ﹤ 0. 01),the left middle occipi-tal gyrus(t = 3. 76,P ﹤ 0. 01),the right middle occipital gyrus/ superior occipital gyrus/ middle temporal gyrus( t =3. 85,P ﹤ 0. 01),left middle temporal gyrus/ superior temporal gyrus(t = 5. 06,P ﹤ 0. 01),the right precuneus/ cuneus (t = 3. 33,P ﹤ 0. 01),and the right superior parietal lo-bule(t = 3. 66,P ﹤ 0. 01),right precentral gyrus(t = 3. 44,P ﹤0. 01),right superior frontal gyrus/ paracentral lobule/ supplementary motor area(t = 3. 50,P ﹤ 0. 01). However,GMV increase was not found. Conclusions Brain GMV extensively decreased in 13 brain regions of IGE patients with typical absence seizure,and among them occipital lobe is the most significant.
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Objective To investigate the value of dynamic contrast?enhanced MRI (DCE?MRI) in the differential diagnosis of glioblastoma and brain metastases. Methods Twenty patients with high grade gliomas and 20 cases patients with brain metastases proved by surgery and pathology were collected, and patients were examined with conventional MRI and DCE?MRI preoperatively. The ROIs were manually placed in solid parts of the tumors and their surrounding tissues to calculate Ktrans, Kep and Ve values. The Ktrans, Kep and Ve values differences for the solid part and surrounding tissues of the two brain tumors were compared by two independent sample t test. The correlation between Ktrans of the solid parts of the two brain tumors and Ktrans, Kep and Ve values of their surrounding tissues were studied by Pearson correlation analysis. Results The Ktrans, Kep and Ve values of glioblastoma were(0.258 ± 0.063)min-1,(0.398 ± 0.082)min-1, 0.632±0.084, the Ktrans, Kep and Ve values of brain metastases were(0.233±0.053)min-1,(0.357±0.042)min-1, 0.672±0.113. There were no significant differences between the glioblastoma and brain metastases for Ktrans, Kep and Ve values(t=-1.354,-1.982, 1.276, all P>0.05). The Ktrans, Kep and Ve values of surrounding tissues of glioblastoma were(0.093±0.032)min-1,(0.411±0.089)min-1, 0.107±0.021, the Ktrans, Kep and Ve values of surrounding tissues of brain metastases were(0.033±0.010)min-1,(0.204±0.045)min-1, 0.069±0.017. The Ktrans, Kep and Ve values of surrounding tissues between glioblastoma and brain metastases had significant difference (t=-7.978,-9.303,-6.203, all P0.05). Conclusion The DCE?MRI can quantitatively display the microvascular permeability and accurately evaluate the damage of blood?brain barrier of glioblastoma and brain metastases, which has an important value in studying biological characteristics and differential diagnosis of the two brain tumors.
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Objective To investigate cognitive impairment mechanism by studying dorsolateral prefrontal cortex connectivity in patients with primary insomnia.Methods Forty patients with primary insomnia and 50 healthy subjects from the Department of Neurology,People's Hospital of Zhengzhou University during the period April 2011 through April 2013 were included.The World Health OrganizationUniversity of California Los Angeles Auditory Verbal Learning Test (WHO-UCLA AVLT) and the digital pin test were applied to evaluate the subjects' word study ability and vigilance.Resting state functional magnetic resonance imaging was used to observe the connectivity of dorsolateral prefrontal cortex.Results The Pittsburgh Sleep Quality Index (2.00 (1.00,3.00)) and the Hamilton Anxiety Scale scores (13.00 (11.25,15.75)) of primary insomnia patients were significantly higher than that of healthy controls (11.00(9.00,13.00),1.00 (0,2.00),Z=-5.517,Z=-5.525,P＜0.01).Digital pin test efficiency (60.03％ ± 13.95％ vs 66.32％ ± 13.73％,t =2.142,P＜0.05) and WHO-UCLA word learning (10.11 ± 2.29 vs 11.95 ± 2.42,t =-3.493,P ＜ 0.01) of primary insomnia patients were significantly lower than that of healthy controls.Compared to the healthy controls,the right dorsolateral prefrontal cortex of primary insomnia patients exhibited decreased functional connectivity of the right prefrontal lobe (-2.610 3 ± 0.172 6,t =-3.504,P ＜ 0.05).The left dorsolateral prefrontal cortex of primary insomnia patients exhibited increased functional connectivity of the bilateral insular lobes and right prefrontal lobe (2.8204±0.326 5,2.371 7 ±0.106 6,2.492 6 ±0.052 8,t =4.032,t =3.340,t =3.037,P ＜0.05).Conclusions The ability of WHO-UCLA word study and the digital pin test efficiency have been shown to decline in patients with primary insomnia.The possible mechanism of cognitive impairment may be the abnormal dorsolateral prefrontal cortex connectivity in patients with primary insomnia.