Study On Brain Structure And Resting State FMRI In Children With Congenital Sensorineural Hearing Loss

Objective To study the correlation between brain gray matter density,resting state brain function and the language recovery after artificial cochlear implantation(CI)in children with congenital sensorineural hearing loss(CSNHL),based on voxel morphometry(VBM),functional magnetic resonance imaging(f MRI)technology based on whole brain local coherence(Re Ho)and brain functional connectivity(FC)analysis were applied to explore the neural remodeling mechanism of CSNHL.Methods MRI data of congenital deafness were collected from 117 children suffering from congenital acoustic neural hearing loss,117 of them met the requirements of the group of gray matter density analysis and 74 cases met the requirements of the resting state brain function analysis,whom were divided into three groups according to the standard of speech intelligibility(SIR)assessed from post-CI children by 6-month follow-up.DPARSFA 3.2,SPM 12 and SPSS16.0 software were used to analyze MRI data of patients with brain structures data,local consistency(Re Ho)data,the whole brain functional connection(FC)data with the right temporal gyrus and posterior cingulate gyrus as seed points and the SIR clinical score after CI.One-way ANOVA analysis,multiple comparisons and correlation analysis were performed to analyze the differences of brain gray matter density and brain function between all groups.Results1 Gray matter density analysis1.1 ANOVA analysis of brain areas with significant difference in gray matter density in three groups of patients including left upper frontal gyrus,left inferior frontal gurus,left anterior cingulate gyrus,posterior cingulate gyrus,left occipital gyrus,bilateral fusiform gyrus,right superior temporal gyrus(P<0.005).The density of these areas were all significantly correlated with SIR score(P<0.05).1.2 Multiple comparative analysis of gray matter density in three groups of patients showed that the density in the higher score group was higher than that in the lower group in brain areas including the left inferior frontal gyrus,the left central posterior gyrus,the left supramarginal gyrus,the right middle temporal gyrus,and the posterior cingulate gyrus.Density of the higher score group was higher than that of the medium scores group in brain areas including bilateral superior frontal gyrus,left precentral gyrus,right postcentral gyrus,right superior temporal gyrus,right calcarine cortex,left precuneus,bilateral fusiform gyrus,posterior cingulate gyrus,left occipital gyrus,left putamen,right thalamus.No gray matter density in middle group was higher than that in low group.(P<0.001)2 The analysis results of Re Ho data2.1 The Re Ho data of three groups of CSNHL children were analyzed by ANOVA.The cerebral regions with statistically significant changes included left upper frontal gyrus,left lateral gyrus,left anterior cuneus lobe,left middle occipital gyrus,right middle temporal gyrus and right occipital gyrus.(P<0.005)?2.2 Multiple comparison analysis on Re Ho data showed that the lower score group was higher than that in the medium group in brain areas including left superior frontal gyrus,right superior frontal gyrus.Multiple comparison analysis on Re Ho data showed that the higher score group was higher than that in the lower group in brain areas including left superior frontal gyrus,right middle temporal gyrus.Multiple comparison analysis on Re Ho data showed that the higher score group was higher than that in the medium group in brain areas including left angular gyrus,left middle frontal gyrus,left occipital gyrus,right inferior frontal gyrus.Multiple comparison analysis on ReHo data showed that the medium score group was higher than that in the lower group in brain areas including left middle occipital gyrus,right middle temporal gyrus.Multiple comparison analysis on Re Ho data showed that the higher score group was higher than that in the lower group in brain areas including left direct gyrus,left middle occipital gyrus,medial and paracentral cingulate gyrus.Multiple comparison analysis on Re Ho data showed that the medium score group was higher than that in the higher group in brain areas including the left supramarginal gyrus,left superior frontal gyrus,left precuneus,right superior frontal gyrus,right away The peripheral cortex and the right inferior occipital gyrus.(P<0.001)?3 The analysis results of FC data3.1 The FC of right middle temporal gyrus in patients groups of CSNHL children were analyzed by ANOVA.The cerebral regions with statistically significant changes included bilateral posterior central gyrus,bilateral upper frontal gyrus,bilateral frontal gyrus,bilateral margin upper gyrus,right olfactory cortex and right inferior frontal gyrus.(P<0.005)?3.2 Multiple comparison analysis on FC of right middle temporal gyrus in patients groups show that,compared with the medium group,the brain regions of the lower group brain function connection were enhanced in bilateral superior frontal gyrus,right pallidum.Compared with the higher group,the brain regions of the lower group brain function connection were enhanced in bilateral superior frontal gyrus,bilateral middle frontal gyrus,left straight back,left side supramarginal gyrus,inferior parietal lobe,left temporal gyrus,right angular gyrus and right supramarginal gyrus.Compared with the higher group,the brain regions of the medium group brain function connection were enhanced the bilateral middle frontal gyrus,bilateral supramarginal gyrus,bilateral postcentral gyrus,right superior frontal gyrus,right inferior frontal gyrus and right middle temporal gyrus.Compared with the lower group,the brain area with no brain function connection were enhanced in the medium group.Compared with the lower group,the brain area with no brain function connection were enhanced in the higher group.Compared with the medium group,the brain area with no brain function connection was enhanced in the higher group.(P<0.001)?3.3 The correlation analysis between the whole brain functional connection(FC)of the right temporal gyrus and the SIR score after CI operation in children show that,no functional connection between the brain area and the right temporal gyrus were positive.The whole brain and the posterior cingulate function connected brain regions negatively correlated with the left superior frontal gyrus,left supramarginal gyrus,left parietal gyrus and right middle temporal gyrus.(P<0.001)?3.4 The FC of posterior cingulate gyrus in patients groups of CSNHL children were analyzed by ANOVA.The cerebral regions with statistically significant changes included left middle frontal gyrus,left precentral gyrus,left superior temporal gyrus,left fusiform gyrus,right superior frontal gyrus,right inferior parietal lobe,right postcentral gyrus,right precentral gyrus and right lingual gyrus.(P<0.005)3.5 Multiple comparison analysis on FC of posterior cingulate gyrus in patients groups show that,compared with the medium group,the brain regions of the lower group brain function connection were enhanced in the left superior frontal gyrus.Compared with the higher group,the brain regions of the lower group brain function connection were enhanced in the left middle frontal gyrus,left angular gyrus,right superior frontal gyrus and right parietal gyrus.Compared with the higher group,the brain regions of the medium group brain function connection were enhanced in the left inferior frontal gyrus,left superior parietal gyrus,right superior frontal gyrus,right lingual gyrus and right inferior temporal gyrus.Compared with the lower group,the brain regions of the medium group brain function connection were enhanced in left precentral gyrus,right postcentral gyrus and right superior parietal gyrus.Compared with the lower group,the brain regions of the higher group brain function connection were enhanced in left superior temporal gyrus,right superior frontal gyrus,right inferior occipital In the right anterior central gyrus.Compared with the medium group,the brain regions of the higher group brain function connection were enhanced in left superior frontal gyrus,left inferior frontal gyrus,left fusiform gyrus and right frontal gyrus.(P<0.001)3.6 The correlation analysis between the whole brain functional connection(FC)of posterior cingulate gyrus and the SIR score after CI operation in children show that,The whole brain and the posterior cingulate function connected brain regions positively correlated with the left supplementary motor area,the right upper frontal gyrus,and the right temporal gyrus.The whole brain and the posterior cingulate function connected brain regions negatively correlated with the left frontal gyrus,left angular gyrus,right superior frontal gyrus,right middle frontal gyrus,right inferior parietal lobe and right lingual gyrus(P<0.001)?Conclusion The level of postoperative speech recovery in pediatric congenital sensorineural hearing loss is significantly correlated with changes of brain gray matter density of visual-auditory cortex and brain regions of default mode network.The change of brain function in some brain regions may be related to compensatory or remodeling,while the compensatory function of visual cortex often appears in CSNHL children with better postoperative recovery.