Resting State Functional Magnetic Resonance Imaging Study Of Flail Arm Syndrome Based On ReHo And ALFF Methods

Objective: Flail arm syndrome(FAS)is a slowly progressive aggravation of motor neuron disease.The main clinical feature is that the patient's muscle atrophy is limited to the upper limbs,mainly in the proximal and shoulder regions of the upper arm,and the shoulders are drooping.The special posture of the arms and forearms with internal rotation of the hands,the survival period is about 5?10 years old than the classic amyotrophic lateral sclerosis.The incidence of FAS is low and clinical research is relatively rare.FAS patients have limited physical activity and it is difficult to complete the corresponding tasks.Resting-state functional MRI(RS-fMRI)does not need to consider the influence of external conditions,and does not require active participation of the patient.It is only necessary for the subject to lie flat and keep the eyes closed or blinked.A study of spontaneous activity of magnetic resonance signals by studying blood oxygenation level-dependent(BOLD)in the brain is particularly suitable for patients with FAS.In this study,functional oxygenation(BOLD-fMRI)in the brain was used to study the spontaneous brain function of patients with flail-arm syndrome(FAS),and to explore the significance of abnormal brain region changes in the diagnosis of FAS.Provide new imaging evidence for clinical diagnosis and treatment of patients with FAS.Methods: This study used GE Signa 3.0T superconducting magnetic resonance scanner to identify 13 patients with flail arm syndrome diagnosed from January 2015 to August 2018 in the First Hospital of China Medical University and 12 healthy volunteers recruited during the same period.Conduct detailed medical history enquiries,perform routine laboratory tests and necessary scales for RS-fMRI scans,case group meets the diagnostic criteria for clinically diagnosed EI-Escorial standards in 2000,use resting state data The processing assistant(DPARSF)software preprocesses the image data.The preprocessing includes: first removing the data of the first 10 time points of each subject to exclude the instability of the initial magnetic field conversion and the interference of the subject's adaptation stage.Perform time correction and head motion correction for the remaining 150 time points(excluding subjects whose head movement parameters are greater than 3 mm or rotation angle greater than 2 in any direction),and normalize alltested fMRI images using the EPI template(set The voxel size is resampled to 3mm ×3mm × 3mm),Gaussian smooth(6mm full width at half maximum),and linear drift.The local consistency(ReHo)value and the low frequency amplitude(ALFF)value of the two groups of subjects were extracted for statistical analysis.The SPM12 software was used to analyze the analysis of the two subjects and compare the differences between the two groups.Results: 13 confirmed FAS patients and 12 healthy volunteers completed a resting MRI scan,and excluded 5 unqualified subjects(including 3 patients and 2 healthy controls),and finally selected gender,age,and subject.10 students in the FAS group with education and matching,and 10 in the healthy control group were included in the analysis of fMRI data.The results showed that: in the resting state,1.ReHo analysis:(1)Inter-group analysis: Compared with the healthy control group,the patients in the FAS group were in the bilateral anterior wedge,the left posterior cingulate,and the left wedge.The values increased,bilateral central sulcus,left central anterior gyrus,left central posterior gyrus,bilateral medial and lateral sacral gyrus,and right island leaf ReHo decreased(Alpha Sim correction,P<0.05,voxels>20),the difference is statistically significant.(2)Brain regions with significant differences in ReHo were used as ROI,and the ReHo values of each region were extracted and correlated with ALSFRS-R scores.The results showed that the ReHo values of the brain regions with significant differences in ReHo and the ALSFRS-R scores were not found.Significant correlation(r=0.273,P=0.696).2.ALFF analysis:(1)Inter-group analysis: In the resting state,compared with the normal control group,the FAS group was bilaterally anterior wedge,left wedge,posterior cingulate,occipital gyrus,middle iliac crest,The ALFF value of the mid-occipital gyrus,the gyrus,and the lower margin of the brain was lower than that of the normal control group,but no brain area with increased ALFF in the FAS group was found(Alphasim correction,P<0.05,voxel value>54).(2)Brain regions with significant differences in ALFF were used as ROI,and the correlation between ALFF values and ALSFRS-R scores in each region was analyzed.The results showed that the ALFF values of the brain regions with significantly reduced ALFF and the ALSfunctional grading(ALSFRS-R)scores were not correlated(r=0.142,P=0.726).Conclusion: The combination of local consistency(ReHo)and low-frequency amplitude(ALFF)can more comprehensively detect the brain regions of abnormal BOLD signals caused by abnormal brain activity in the brain of patients with FAS,and can evaluate the efficacy of the disease.Prognostic judgment provides some help,and it also provides a basis for further understanding of the neuropathological mechanism of FAS patients.