Multimodal MRI Study And Clinical Correlation On Function And Structure Of Amygdala In Neuromyelitis Optica Spectrum Disorders

Purpose:Using 3.0T resting-state functional MRI(rs-fMRI)and diffusion tensor imaging(DTI),the amygdala was used as the region of interest.Resting-state functional connection(FC)and voxel-based analysis(VBA)were used to investigate the changes of amygdala function and microstructure in neuromyelitis optica spectrum disorders(NMOSD)and their correlation with clinical scores such as anxiety and depression,in order to explore the pathogenesis and clinical research of anxiety and depression in patients with NMOSD.Methods:24 NMOSD patients(NMOSD group)and 24 healthy controls(HC group)were selected.All subjects were assessed with hamilton depression(HAMD)scale,hamilton anxiety(HAMA)scale,montreal congnitive assessment(MoCA),expanded disability status scale(EDSS).The subjects were subjected to BOLD-EPI,3DT1W1,and DTI scans using a 3.0T magnetic resonance scanner.The functional connectivity coefficients between the left and right amygdala and the whole brain were calculated by FC analysis method,and the differences between the two groups in functional connections between the amygdala and the whole brain were compared.The differences of fractional anisotropy(FA)and mean diffusivity(MD)of the amygdala in both groups were compared by VBA.SPSS23.0 software was used to perform chi-square test on the incidence of anxiety,depression and sex in the two groups,and two-sample t-tests were performed in general situation and other clinical scores.Correlation analysis was performed between the scores of HAMD,HAMA,EDSS and MoCA in NMOSD group and the values of FC,FA and MD of brain region of different groups.Results:(1)The incidence of anxiety and depression in NMOSD group was significantly higher than that in HC group,and the difference is statistically significant(p?0.05).(2)Compared with HC group,the functional connection was weakened among the left amygdala and bilateral cerebellum posterior lobe,cerebellar tonsil,caudate nucleus,limbic lobe,frontal lobe,putamen,frontal inferior opercular,anterior cingulate,left cerebellum anterior lobe,frontal inferior orbit,lentiform nucleus,claustrum,right insula and superior temporal gyrus;while the functional connection was weakened among the right amygdala and bilateral cerebellum posterior lobe,cerebellar tonsil,caudate nucleus,limbic lobe,anterior cingulate,insula,medial frontal gyrus,frontal lobe,orbital frontal lobe,left cerebellum anterior lobe,right temporal lobe(superior,inferior gyrus),frontal inferior opercular,and claustrum(p ? 0.001,corrected by AlphaSim,voxel?10);No functional connection to enhance brain area.(3)Compared with HC group,the whole brain of NMOSD group had a wide range of increased and decreased on FA values and MD values(p?0.05,corrected by FDR,voxel?50);The value of the left amygdala in the NMOSD group was decreased,and the MD value of the two-sided amygdala was increased(p ? 0.05,corrected by AlphaSim,voxel?10).(4)The FC value of the left amygdala and the right caudate nucleus were negatively correlated with the EDSS score(r=-0.218,p=0.038);The FC value of the left amygdala and the whole brain were positively correlated with the FA value of the left amygdala(r=0.316,p=0.004);There was a positive correlation between HAMA score and EDSS score(r=0.451,p=0.033);There was a negative correlation between HAMA score and MoCA score(r=-0.336,p=0.038);There was a negative correlation between HAMD score and MoCA score(r=-0.488,p=0.041).Conclusions:(1)The incidence of anxiety and depression in NMOSD patients was significantly higher than that in healthy people.(2)The functional connection between the amygdala and the whole brain is weakened in NMOSD patients,and the functional connection between the left amygdala and the right caudate nucleus was negatively correlated with the degree of disability.(3)The microstructure of amygdala was abnormal in NMOSD patients,and the microstructure of left amygdala was positively correlated with the functional connection between ipsilateral amygdala and whole brain.(4)The occurrence of anxiety and depression in NMOSD patients was negatively correlated with cognitive function and positively correlated with disability degree.