木僵患者"失连接假说"的多模态脑网络机制的磁共振研究

Stupor is an extreme consciousness disorder disease，which patients yet have basic consciousness and their behavioral activity are completely inhibited . It’s pathogenesis is unclear. The existence of consciousness is based on the activation of bottom "switching system" which is mainly involved reticular activating system (RAS). RAS diffuse projection to the cerebral cortex and regulate somatic motor function. Our previous researches found stupor patients have incomplete functionality in the projected target area of reticular activating system, default network and the left supplementary motor area (SMA) which shows that Stupor is a special pathological state that the bottom “switch system” is activated but cortical Projection network access get damaged. So author suggest the following hypothesis that stupor is a general brain disconnection in “switch system”,the reticular activating system is core part for “switch system”. Our project take advantage of stochastic dynamic causal modeling analyze the distribution and the information flow of the brain networks in resting state ; "Small world" network model is used to analyze the structural cortical thickness network ; DTI imaging analysis is used to analyze myelin conductive network. Authors hope to identify the network mechanisms of brain damage by deeply research the multimodal brain network topology difference of stupor patients. This study not only provides an important imaging evidence for stupor pathogenesis, but also provides important message to the underlying brain network transmission mechanism of complex cognition of the brain because stupor itself rule out the interference of senior center in the research.

木僵(stupor)是行为活动完全被抑制，仅保留基本意识的极端意识障碍性疾病，其发病机制尚不清楚。意识的存在是以网状激活系统（RAS）为主的底层“开关系统”激活为前提。RAS向大脑皮质弥漫投射，调控躯体运动功能。我们前期研究发现，木僵患者的RAS投射靶区、默认网络及左侧辅助运动区功能性缺失，表明木僵状态是一种底层“开关系统”激活，但皮质投射网络通路损害的特殊病理状态。故提出“木僵状态存在网状激活系统为核心的“开关系统”的广泛脑网络失连接”假说。本项目利用随机动态因果模型，分析静息态有向脑网络的分布及信息流向；利用"小世界"模型，分析灰质结构网络；利用DTI成像，分析白质传导网络。希望深入研究木僵患者多模态脑网络拓扑差异，寻找其脑损害的网络机制。本研究不但为木僵的发病机制提供重要的影像学依据，更因该病本身排除高级中枢在研究中的干扰，将为人脑复杂认知的底层脑网络传导机制提供重要信息。