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目的 通过静息态功能磁共振成像（rs-fMRI）的分数低频振幅（fALFF）和功能连接（FC），观察系统性红斑狼疮（SLE）患者静息态脑功能改变，并分析其与认知功能障碍的关系。方法 选取34例SLE患者（观察组）及33例健康志愿者（对照组）。采用rs-fMRI技术分析两组fALFF和FC改变，采用蒙特利尔认知评估量表（MoCA）评估认知功能。比较两组全脑体素水平fALFF的差异，以组间fALFF存在差异脑区为ROI，分析全脑FC结果，评估SLE患者异常脑区FC与认知功能障碍的关系。结果 与对照组相比，观察组右侧梭状回fALFF增高（t=5.13,P<0.05,FWE校正），右侧梭状回与右侧中央沟盖、右侧颞上回、左侧颞上回、左侧颞中回、左侧舌回FC减低（t分别为-5.962、-5.656、-5.076、-4.677、-4.313,P均<0.05,FWE校正）。观察组MoCA评分显著低于对照组（t=-2.075,P=0.042），主要体现在语言、抽象思维、延迟回忆。相关性分析显示，右侧梭状回-右侧中央沟盖FC与MoCA评分呈正相关（r=0.652,P<0.05,FWE校正）。结论 SLE患者存在语言、抽象思维、延迟回忆的认知功能降低，伴右侧梭状回神经自发活动升高，以及视觉-听觉与语言-感觉运动网络间的协作障碍，其中右侧梭状回与中央沟盖协同功能障碍是导致整体认知功能降低的关键神经环路机制。
Abstract：Objective To investigate resting-state brain functional alterations in patients with systemic lupus erythematosus(SLE) using fractional amplitude of low-frequency fluctuation(fALFF) and functional connectivity(FC) derived from resting-state functional magnetic resonance imaging(rs-fMRI), and to analyze their relationship with cognitive dysfunction. Methods A total of 34 patients with SLE(observation group) and 33 healthy volunteers(control group) were enrolled. Restingstate functional magnetic resonance imaging(rs-fMRI) was used to analyze changes in fractional amplitude of low-frequency fluctuation(fALFF) and functional connectivity(FC) between the two groups, and cognitive function was assessed with the Montreal Cognitive Assessment(MoCA) scale. Voxel-wise differences in whole-brain fALFF were compared between the two groups. Regions showing inter-group differences in fALFF were defined as regions of interest(ROI), and whole-brain FC was analyzed accordingly. The correlation between abnormal FC in brain regions and neuropsychological scale scores in SLE patients was evaluated. Results Compared with the control group, patients in the observation group showed increased fALFF in the right fusiform gyrus(t=5.13, P<0.05, FWE-corrected), and decreased FC between the right fusiform gyrus and the right precentral gyrus operculum, right superior temporal gyrus, left superior temporal gyrus, left middle temporal gyrus, and left lingual gyrus(the t-valuse was-5. 962,-5. 656,-5. 076,-4. 677,-4. 313, respectively, all P<0.05, FWE-corrected). The MoCA scale score of the observation group was significantly lower than that of the control group(t=-2.075, P=0.042), mainly reflected in language, abstraction, and delayed recall. Correlation analysis showed that the FC between the right fusiform gyrus and the right precentral gyrus operculum was significantly positively correlated with the MoCA score(r=0.652, P<0.05, FWE-corrected). Conclusion Patients with SLE exhibit cognitive decline in language, abstraction, and delayed recall, accompanied by increased spontaneous neural activity in the right fusiform gyrus, as well as impaired coordination between the visual-auditory network and language-sensorimotor network. Among these, the dysfunctional coordination between the right fusiform gyrus and the central opercular cortex represents a key neural circuit mechanism underlying global cognitive impairment.
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基本信息:
DOI：10.20258/j.cnki.1006-9011.2026.05.004
中图分类号:R593.241;R445.2
引用信息:
[1]刘同辉,冯伟,张华文,等.基于rs-fMRI的系统性红斑狼疮患者静息态脑功能异常分析及其与认知功能障碍的关系[J].医学影像学杂志,2026,36(05):20-25.DOI:10.20258/j.cnki.1006-9011.2026.05.004.
基金信息:
咸阳市重点研发计划项目（编号：L2025-ZDYF-JBFZ-012、L2024-ZDYF-ZDYF-SF-0004）; 中陕核工业集团有限公司科技攻关项目（编号：61240302）; 陕西健康医疗集团有限公司自立科研项目（编号：SXJKYBXM-2025002）
2026-05-30
2026-05-30