| Purpose:Basing on voxel-based morphological analysis（VBM）,functional magnetic resonance imaging（f MRI）and diffusion tensor imaging（DTI）techniques to explore the changes of cerebellum volume,microstructure and functional connection in patients with neuromyelitis optica spectrum disease,and to discuss the relationship between cerebellar microstructural changes and functional connection changes,and the correlation with clinical disability progression and cognition.To provide imaging basis for the neuropathological mechanism of brain injury in patients with neuromyelitis optica spectrum disease.method:Selection 29 patients with NMOSD treated in China-Japan Friendship Hospital of Jilin University from March 2016 to November 2021 and 10 healthy controls with matched age and sex were collected.All subjects were assessed by Montreal Cognitive Assessment Scale（Mo CA）,Minimental State examinatiin（MMSE）,and Extended Disability Statusscale（EDSS）,Hamilton Depression Scale（HAMD）and Hamilton Anxiety Scale（HAMA）.All subjects were scanned by 3.0T MRI acquisition to obtain 3D-T1,rs-f MRI,and DTI image data.The 3D-T1 images of the subjects were preprocessed by VBM method,and the bilateral cerebellum was taken as the object of study.After statistical correction,the reduced nucleus of cerebellar gray matter volume was obtained.The gray body volume values of different brain regions in patients with NMOSD were extracted and correlated with the clinical evaluation scale.The gray matter volume change cerebellar nucleus was selected as the region of interest（ROI）,and the bilateral cerebellum CrusⅠ,CrusⅡand cerebellum VIII were used as ROI,The values of FA,MD and FC with the whole brain were calculated.The differences between the groups were compared,and the differential brain maps were obtained by statistical test and correction.The correlation analysis between the indexes of differential brain regions and clinical evaluation scale,and the correlation between cerebellar microstructure changes and functional connection changes were analyzed.Before statistical analysis,check the normal distribution of the data,the data are consistent with the use of Pearson correlation analysis,do not conform to the use of Spearman correlation coefficient analysis,p < 0.05 is considered to have significant statistical significance.Results:（1）The incidences of cognitive impairment in the NMOSD group were significantly higher than those in the control group（p < 0.05）;（2）Compared with the control group,VBM analysis showed that the cerebellar gray matter volume reduction nucleus in the NMOSD group was（AAL template）:bilateral cerebellar lobular VIII area,left cerebellar lobular IX area,Vermis VI area,left cerebellar Crus Ⅰ area,left cerebellar Crus II area,bilateral cerebellar lobular VI area（p < 0.001,corrected by FWEc,voxel>1058）.It was not found that the volume of cerebellar gray matter was larger than that of the healthy control group;（3）Taking bilateral cerebellar Crus Ⅰ,Crus Ⅱ and lobular VIII as regions of interest,the functional connections between the left cerebellar Crus Ⅰ and the whole brain were calculated,and the differences between the two groups were compared.it was found that compared with the healthy control group,the left cerebellar Crus Ⅰareas with enhanced functional connections in the NMOSD group included left cerebellar lobular IV-V,left cerebellar lobular VI,left fusiform gyrus,right postcentral gyrus and right supramarginal gyrus（p < 0.001,corrected by FWEc,voxel > 77）.Compared with the control group,the functional connections of the right cerebellar Crus Ⅰ region were weaker than those of the control group,including bilateral middle occipital gyrus,left cerebellar Crus Ⅰ area,bilateral suboccipital gyrus,right triangular inferior frontal gyrus and right middle frontal gyrus（p < 0.001,corrected by FWEc,voxel>112）.The connection between other ROI and whole brain function did not enhance or weaken the brain area compared with the control group.（4）In NMOSD group,the FA value of right cerebellar CrusⅠarea was enhanced（p < 0.05 and corrected by FWEp）,and the MD value of bilateral cerebellar CrusⅠarea and bilateral cerebellar lobular VIII area decreased（p < 0.05 and corrected by GRF,voxel > 365）.（5）In NMOSD group,the volume value of bilateral cerebellar lobule VI was positively correlated with EDSS score（r = 0.392,p = 0.036）,the FC value of right cerebellar Crus I area and right middle occipital gyrus was positively correlated with MMSE score（r = 0.372,p = 0.047）,and the FC value of right cerebellar Crus I region and right triangular infratemporal gyrus was positively correlated with Mo CA score（r = 0.394,p = 0.034）.The MD value of right cerebellar Crus I area was positively correlated with EDSS score（r = 0.398,p = 0.033）.（6）In NMOSD group,there was a positive correlation between FC value and FA value in left cerebellar Crus I region and right postcentral gyrus（r = 0.439,p =0.017）.The FC values of right cerebellar Crus I region and right middle occipital gyrus were negatively correlated with MD values（r = 0.374,p = 0.046）,the FC values of right cerebellar Crus Ⅰ region and left middle occipital gyrus were negatively correlated with MD values（r = 0.480,p = 0.008）,and the gray matter volume of right cerebellar Crus Ⅰ area was positively correlated with FC values of right cerebellar Crus Ⅰ region and right inferior triangular gyrus（r = 0.383,p =0.04）.Conclusion:（1）The incidence of cognitive impairment in NMOSD patients was significantly higher than that in healthy controls,and The abnormal cerebellar and cerebral functional connections in NMOSD patients maybe had an effect on cognitive function;（2）There was interaction and close relationship between cerebellar microstructural changes and functional connections in NMOSD patients;（3）The cerebellar atrophy and the microstructural abnormality of cerebellum in NMOSD patients possibly had an effect on the progression of disease disability;... |
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