Functional Connectivity And Gray Matter Volume Changes In Neurosyphilis Patients Based On Rs-fMRI

ObjectiveUsing the resting-state functional magnetic resonance imaging(rs-fMRI)technology to analyze the brain functional connectivity and the gray matter volume in patients with neurosyphilis.Summarize the changes in brain functional connectivity and gray matter volume in neurosyphilis patients,and explore the correlation between changes of brain functional connectivity and laboratory examinations.Collect the clinical data of neurosyphilis patients,and sum up the risk factors of neurosyphilis.Methods1、Choose 15 neurosyphilis patients diagnosed in Zhongda Hospital affiliated to Southeast University from November 2015 to February 2022 and 17 patients without neurosyphilis.The right middle frontal gyrus,right precuneus,left posterior cingulate gyrus(PCC),right PCC,and the right dorsolateral superior frontal gyrus were used as the seed points to conduct brain functional connectivity,and analyze the correlation between the functional connectivity strength of different brain regions and laboratory examinations.2、Choose 15 neurosyphilis patients diagnosed in Zhongda Hospital affiliated to Southeast University from November 2015 to February 2022 and 15 matched healthy controls to conduct the voxel-based gray matter morphological analysis.3、Collect the clinical data of patients diagnosed with neurosyphilis and syphilitic serofast patients in Zhongda Hospital Affiliated to Southeast University from October 2014 to February 2022,and analyze the clinical characteristics and risk factors of neurosyphilis.Results1、brain functional connectivity changes in neurosyphilis patients and its correlation with laboratory examinationsCompared with non-neurosyphilis patients,the right precuneus showed increased functional connectivity with the left temporal pole/superior temporal gyrus and the left dorsolateral superior frontal gyrus,while the functional connectivity between left PCC and the left median cingulate and paracingulate gyrus was enhanced in the neurosyphilis group(voxel level P<0.01,cluster level P<0.05,Alphasim Correction).There were no differences in the functional connections between the right middle frontal gyrus,right PCC,right dorsolateral superior frontal gyrus and whole brain voxels in neurosyphilis patients.In neurosyphilis patients,the right precuneus and left temporal pole/superior temporal gyrus were negatively correlated with serum Treponema pallidum antibody(chemiluminescence method)(P=0.025),and positively correlated with serum albumin level(P=0.047)).The functional connection strength between the right precuneus and the left dorsolateral superior frontal gyrus was negatively correlated with serum Treponema pallidum antibodies(P=0.006).And the functional connection strength between the left PCC and the left median cingulate and paracingulate gyrus was negatively correlated with whether the RPR of cerebrospinal fluid was higher than or equal to 1: 16 at the time of lumbar puncture(P=0.045).2、Brain gray matter volume changes in patients with neurosyphilisCompared with healthy controls,patients with neurosyphilis had a smaller volume of gray matter in the right middle temporal gyrus(P<0.01 voxel level,cluster level P<0.05,Alphasim correction).3、Analysis of risk factors for neurosyphilisSerum RPR titer higher than or equal to 1:16 during lumbar puncture,leukocyte count in cerebrospinal fluid higher than 5×106/L,increased Ig G level in cerebrospinal fluid,and no treatment were risk factors for neurosyphilis.Conclusion1、 There are changes in brain functional connectivity of neurosyphilis patients,and there is a correlation between the strength of abnormal functional connectivity and laboratory examinations.2、 Decreased gray matter volume of right middle temporal gyrus in neurosyphilis patients may be an early predictor of neurosyphilis.3、 Patients with serum RPR titer higher than or equal to 1:16 at lumbar puncture,cerebrospinal fluid leukocyte count higher than 5×106/L,cerebrospinal fluid IgG level increased,and untreated patients have a higher risk of neurosyphilis.