| Objective In this study,large-scale functional brain network,local brain function,independent component analysis,functional connectivity and other research methods were applied based on resting state functional magnetic resonance imaging technology to analyze the features of functional brain network in patients with high white matter signal,and to analyze the central effect mechanism of syndrome in patients with WMH from the perspective of kidney deficiency and depression.In order to provide a reliable reference for the diagnosis and treatment of white matter high signal extreme syndrome of traditional Chinese medicine.Methods In this study,patients over 40 years old with high white matter signal were enrolled,and a matched number of healthy subjects were recruited.General information and neuropsychiatric scale assessment of the subjects were collected at the time of enrollment,and fMRI data were collected.According to the four diagnosis information of traditional Chinese medicine,the patients were divided into kidney deficiency group and non-kidney deficiency group.According to the Hamilton Depression Scale score at the time of enrollment,the patients with high white matter signal were divided into depression group and non-depression group.Syndrome elements collected from patients with high white matter signal were analyzed by frequency analysis,large-scale brain network changes in patients with high white matter signal were analyzed by graph theory,local consistency and low-frequency oscillation amplitude were analyzed for local brain function changes in patients with high white matter signal signal,and brain network conditions in white matter high-signal kidney deficiency group and non-kidney deficiency group were analyzed by independent components.According to the previous study and the baseline of this study,seed points were selected for the whole brain functional connectivity analysis of patients with white matter high signal depression based on seed points.Results A total of 27 patients with high white matter signal were included in this study,which were from the outpatient department and ward of Dongzhimen Hospital of Beijing University of Chinese Medicine.26 healthy subjects were recruited,and no cases were shed or eliminated.1.In the 27 patients with high white matter signal included in this study,more than 50%of the symptoms of syndrome frequency included dizziness,difficulty falling asleep.fatigue and headache.According to the four diagnosis information scale of traditional Chinese medicine,the white matter high signal group was divided into 13 cases in the kidney deficiency group and 14 cases in the non-kidney deficiency group.According to the score of Hamilton Depression Scale,12 cases were depressed and 14 cases were non-depressed.2.The large-scale brain network analysis of patients with high white matter signal found that the functional brain network of patients with high white matter signal had "small-world" attribute,but the smallworld attribute had a downward trend compared with healthy people,and other brain indexes such as characteristic path length and network efficiency had no significant change compared with healthy control group.Edge analysis showed that compared with the healthy control group,functional connections in the dorsal superior frontal gyrus,talobate fusiform gyrus and surrounding cortex,dorsal superior frontal gyrus and lingual gyrus,medial superior frontal gyrus and lingual gyrus,parahippocampal gyrus and lingual gyrus,medial superior frontal gyrus and suproccipital gyrus,lingual gyrus and putamen,lingual gyrus and transverse temporal gyrus were weakened in the white matter high signal group.3.In the local consistency(ReHo)and low-frequency amplitude analysis(ALFF),two clusters of ALFF were significantly reduced in the white matter high-signal patients compared with the healthy control group,after P<0.001 cluster>30.The area with the largest correction difference was located in the frontal lobe,including the inferior frontal gyrus and the middle frontal gyrus.Compared with the healthy control group,white matter high signal level significantly decreased in 2 clusters and significantly increased in 1 cluster after P<0.001,cluster>30.After correction,the brain regions with significant decrease of ReHo generally included cuneus and parietal lobes,while the brain regions with significant increase of ReHo were mainly located in temporal lobe.3.The 30 independent components obtained by ICA decomposition in the kidney deficiency group and the non-kidney deficiency group were analyzed,and it was found that compared with the non-kidney deficiency group,the default mode network,auditory network and visual network connections were weakened in the kidney deficiency group,while the default mode network and rated network connections were strengthened.4.The functional connectivity of seed points in depressed group and non-depressed group was as follows:(1)The functional connectivity between depressed patients and left hippocampus mainly increased in left cingulate gyrus,medial frontal lobe,corpus callosum,anterior cingulate gyrus,and paracingulate gyrus.The brain regions with increased functional connections to the right parahippocampal gyrus included the lower outer occipital lobe;(2)The functional connectivity between depressed patients and right prefrontal cortex mainly increased in precuneus,right precuneus,frontal lobe,etc.The functional connections with the anterior cingulate cortex decreased in the temporal lobe,right angular gyri,right occipital lobe,etc.③ The functional connectivity between depressed patients and left parietal cortex was increased mainly in the right angular gyrus,occipital lobe,temporal lobe,etc.P<0.001 cluster>30 correction;6.Multiple regression analysis of the ALFF value of WMH patients and HAMD scale found that the two areas were positively correlated with the peritalobiate cortex,primary visual cortex-striate cortex,secondary visual cortex-middle occipital gyrus,left cuneus,parietal lobule,right precuneus,secondary visual cortex-infroccipital gyrus,posterior cingulate gyrus and other areas(P<0.001,cluster level,k>30).Conclusion 1.Patients with high white matter signal may show dizziness,insomnia,fatigue,headache and other symptoms,and about half of the population is accompanied by depression,but no cognitive function decline.2.The functional brain network of patients with high white matter signal has small-world attribute,but the separation,integration and balance of the brain network are disordered,the mechanism of which may be related to the weakened connections between brain regions.3.The connections between the default mode network and multiple brain networks were changed in WMH patients with kidney deficiency syndrome.In WMH patients with depression,the hippocampus,prominence network and default mode network were used as seed points to change connections with a wide range of brain regions. |
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