摘要：

目的 探讨轻度认知损害患者皮质下核团体积与空间导航能力之间的关系。 方法 采用计算机空间导航障碍测试系统测试30 例轻度认知损害患者和性别、年龄、受教育程度相匹配的28 例正常对照者空间导航能力，FreeSurfer 5.3.0 软件对三维T1WI 图像进行结构分割，计算皮质下核团（双侧丘脑、尾状核、壳核、苍白球、海马、杏仁体和伏隔核）体积以及全脑体积。Pearson 相关分析分析空间导航能力与皮质下核团体积的相关性。 结果 轻度认知损害患者混合（环境参照和自我参照）导航（P =0.034）、自我参照导航（P = 0.004）、环境参照导航（P = 0.011）误差距离均大于正常对照者，而双侧丘脑（P = 0.953，0.250）、尾状核（P = 0.938，0.672）、壳核（P = 0.421，0.912）、苍白球（P = 0.446，0.360）、海马（P =0.545，0.647）、杏仁体（P = 0.565，0.993）、伏隔核（P = 0.271，0.796）和全脑（P = 0.567）体积组间差异无统计学意义。Pearson 相关分析显示，轻度认知损害患者混合（环境参照和自我参照）导航误差距离与左侧苍白球（r = - 0.284，P = 0.034）和左侧海马（r = - 0.265，P = 0.048）体积呈负相关，环境参照导航误差距离与左侧壳核体积呈负相关（r = - 0.305，P = 0.022）。 结论 轻度认知损害患者空间导航能力与皮质下核团体积相关，对进一步研究空间导航障碍的发生机制具有重要意义。

关键词: 认知障碍, 神经导航, 基底神经节, 磁共振成像

Abstract:

Objective  To evaluate the correlation between subcortical nuclei volume and spatial navigation performance in patients with mild cognitive impairment (MCI). Methods  Thirty MCI subjects and 28 healthy controls matched in gender, age and education were enrolled in this study, and all of them underwent 3.0T MRI scan and computer version spatial navigation test. The three-dimensional turbo fast echo (3D - TFE) T1WI structures were segmented by FreeSurfer 5.3.0 software. The volume of bilateral thalami, caudate nuclei, putamen, globus pallidi, hippocampi, amygdaloid bodies, nuclei accumbens septi and whole brain were calculated. Pearson correlation analysis was performed to investigate the correlation between spatial navigation performance and subcortical nuclei volume.  Results  MCI patients showed longer allocentric-egocentric virtual distance error (P = 0.034), egocentric virtual distance error (P = 0.004) and allocentric virtual distance error (P = 0.011) than control subjects, while the volume of bilateral thalami (P = 0.953, 0.250), caudate nuclei (P = 0.938, 0.672), putamen (P = 0.421, 0.912), globus pallidi (P = 0.446, 0.360), hippocampi (P = 0.545, 0.647), amygdaloid bodies (P = 0.565, 0.993), nuclei accumbens septi (P =0.271, 0.796) and whole brain (P = 0.567) showed no significant differences between 2 groups. Pearson correlation analysis showed allocentric-egocentric virtual distance error was negatively related to the volume of left globus pallidum (r = -0.284, P = 0.034) and left hippocampus (r = .0.265, P = 0.048), and allocentric virtual distance error was negatively related to the volume of left putamen (r = -0.305, P = 0.022) in MCI subjects.  Conclusions  There are correlations between spatial navigation performance and subcortical nuclei volume in MCI patients, and it is significant in further study of the mechanisms of human spatial navigation disturbance.

Key words: Cognition disorders, Neuronavigation, Basal ganglia, Magnetic resonance imaging