Study On Exploring The Central Mechanism Of Multimodal MRI In Patients With Moderate And Severe OSAHS Based On Neurovascular Unit

Objective:Based on the concept of "neurovascular unit",this study applied the multi-mode magnetic resonance imaging technology which combines the local brain function changes and abnormal connections of resting-state functional magnetic resonance imaging,magnetic resonance spectroscopy imaging,and arterial spin labeling imaging.To investigate the central mechanism of brain function changes in patients with moderate and severe obstructive sleep apnea-hypopnea syndrome(OSAHS),to provide a new prediction and evaluation method for clinical recognition of OSAHS and related central nervous system diseases.Therefore,it provides the corresponding theoretical basis and clinical guidance for the means of disease rehabilitation.Methods:Sixteen patients with moderate to severe OSAHS were included in the experimental group and 15 healthy volunteers were in the control group(GN).3.0T magnetic resonance scanner(Philips Achieva,Nederland)performed resting-state functional magnetic resonance imaging(fMRI),arterial spin labeling,and magnetic resonance spectrum scanning to collect regional homogeneity(ReHo),amplitude of low-frequency fluctuations,ALFF)and related image data of functional connectivity analysis,cerebral blood flow,and cerebral region metabolism;General data of the two groups,montreal cognitive assessment scale(MoCA)and epworth sleeping scale(ESS)scores,and statistical analysis were collected was carried out using SPSS 19.0.Relevant image data of patients with different MRI sequences were collected,and statistical analysis was performed based on the Matlab2012a platform with the DPABI software package.Results:OSAHS patients showed no significant differences in age,sex,and years of education between healthy volunteers and OSAHS patients(P>0.05);Apnea hypopnea index and Epworth narcolepsy scale scores were significantly higher than those of the GN group.The lowest oxygen saturation and Montreal Cognitive scale scores were significantly lower than those in the GN group(P<0.001),the difference was statistically significant;ALFF value increased in brain regions dominated by the brain stem and left insula(Figure 1-1),and ReHo value increased in brain regions dominated by left superior temporal gyrus and left anterior central gyrus,while ReHo value decreased in brain regions dominated by right middle temporal gyrus,right transverse temporal gyrus,and right superior limbal gyrus.The functional connections between the left superior temporal gyrus and the brain regions dominated by the supplementary motor area and the brain regions dominated by the inferior temporal gyrus were weakened.The functional connections between the right temporal transverse gyrus and the brain regions dominated by the middle frontal gyrus and the brain regions dominated by the central anterior gyrus were weakened.Functional connections in the left anterior central gyrus fusiform gyrus and superior limbic gyrus were weakened,while functional connections in the inferior temporal gyrus and inferior frontal gyrus of the third foot were strengthened.Functional connections between the right superior limbic gyrus,the dorsolateral superior frontal gyrus,and the superior temporal gyrus were weakened,while functional connections between the angular gyrus were strengthened.The ReHo value in the left superior temporal gyrus was significantly positively correlated with MoCA and negatively correlated with an apnea-hypopnea index(P<0.05);There was a significant negative correlation between the ReHo value and MoCA in the precentral gyrus(P<0.05);The metabolite ratio in the hippocampus was lower than that in GN group,and the difference was not statistically significant(P>0.05);Local CBF in the hippocampus,temporal lobe and anterior central gyrus decreased,while local CBF in brainstem and insula increased,the difference was not statistically significant(P>0.05).Conclusion:Based on the "neurovascular unit",a comprehensive analysis of local brain activity,functional connectivity between brain regions,cerebral blood flow,and brain metabolism was conducted by the multi-modal magnetic resonance imaging method.We observed that the higher the neuronal activity and energy consumption in the regions with high brain activity,the higher the cerebral blood flow in the corresponding regions.It is expected to provide a new prediction and evaluation method for clinical recognition of OSAHS and related central nervous system diseases.