接触性热痛刺激健康成年人诱发的脑功能磁共振成像初步研究  

The brain functional magnetic resonance imaging characteristics induced by contact heat stimulations in normal adults

作　　者：谭娟[1] 王晓明[1] 罗成[2] 涂世鹏 崔文娟[1] 张耀丹[1] 

机构地区：[1]川北医学院附属医院神经内科,四川省南充市637000 [2]电子科技大学神经信息教育部重点实验室

出　　处：《中华神经科杂志》2014年第5期331-335,共5页Chinese Journal of Neurology

摘　　要：目的 观察健康人群在不同温度接触性热痛刺激（CHS）下兴奋Aδ和C纤维伤害性感受器的功能磁共振成像（fMRI）特征,探索痛觉相关脑网络,评价接触性热痛刺激-功能磁共振成像（CHS-fMRI）在脑功能连接研究中的价值.方法 选择健康成年受试者22名,对所有受试者分别进行41℃（41℃CHS-fMRI组）和51℃（51℃CHS-fMRI组）CHS任务态fMRI扫描.分别观察两种不同的温度CHS下的脑区激活情况及41℃CHS-fMRI组和51℃CHS-fMRI组之间的激活差异.结果41℃CHS-fMRI组（n=22）激活脑区包括：双侧颞上回、对侧颞横回、对侧杏仁核、双侧岛叶、双侧额下回、对侧海马、双侧壳核、对侧缘上回、同侧中央后回、同侧顶下缘角回、同侧颞中回、双侧小脑、双侧中扣带回、双侧后扣带回;51℃CHS-fMRI组（n=22）激活脑区包括：双侧颞上回、双侧杏仁核、对侧海马、双侧丘脑、对侧壳核、双侧岛叶、双侧额下回、双侧小脑、对侧中央后回、对侧顶上回、双侧颞中回、双侧楔前叶、对侧楔叶;配对t检验显示,5l℃刺激较41℃刺激显著增高的血氧水平依赖（BOLD）反应区（激活强度值）包括（=2.83,P＜0.01）：双侧小脑（右：4.455、左：3.891）、同侧楔前叶（4.150）、对侧岛叶（3.530）、对侧额下回（3.530）、对侧中央后回（3.530）.结论 41℃和51℃两个温度刺激激活的脑区有共同拥有的结构和各自特异的部分,且部分重叠的脑结构区的BOLD反应强弱仍存在差异,表明Aδ和C纤维可能在激活中枢径路有两套传导通路,在司痛觉中作用不一,可能拥有各自的脑网络,CHS-fMRI可作为研究痛觉相关脑网络的理想手段之一.Objective Aδ and C fiber nociceptors can be excited when people received contact heat stimulation（CHS） and this excitation may be reflected by functional magnetic resonance imaging（fMRI）.The aim of this study was to observe the different fMRI characteristics in CHS with distinct temperatures in healthy people and to explore the pain related functional network.Depending on the fMRI results,we can evaluate the values of CHS-fMRI during the research of brain functional connectivity.Methods Twenty-two healthy volunteers were recruited to this study.During the acquisition of fMRI,the right dorsal forearm received two different CHS in 41 and 51 degree respectively（41 ℃ CHS-fMRI group and 51 ℃ CHS-fMRI group）,and two series of fMRI data were obtained for each subject.The brain activation was obtained by using one sample t test for the 41 ℃CHS-fMRI group and 51 ℃CHS-fMRI group separately.The difference between 41 ℃ CHS-fMRI group and 51 ℃ CHS-fMRI group was analyzed by paired-sample t-test.Result These activated brain areas in 41 ℃ CHS-fMRI group included bilateral superior temporal gyrus （STG）,contralateral transverse temporal gyrus,contralateral amygdala,bilateral insula,bilateral inferior frontal gyrus （IFG）,contralateral hippocampus,bilateral putamen,contralateral supramarginal,ipsilateral postcentral,ipsilateral inferior parietal lobule,ipsilateral middle temporal gyrus （MTG）,bilateral cerebelum,bilateral middle cingulate cortex and bilateral posterior cingulate cortex.These activated brain areas in 51 ℃ CHS-fMRI group included bilateral STG,bilateral amygdala,contralateral hippocampus,bilateral thalamus,contralateral putamen,bilateral insula,bilateral IFG,bilateral cerebellum,contralateral postcentral,contralateral superior parietal lobule,bilateral MTG,bilateral precuneus,and contralateral cuneus.Compared with 41 ℃ CHS-fMRI group,the 51 ℃ CHS-fMRI group showed higher brain activation in bilateral cerebellum （right：4.455,left：3.891）,ipsilateral precuneus （4.150

关 键 词：痛觉过敏 热 磁共振成像 脑 神经纤维 无髓鞘的 神经纤维 有髓鞘的 

分 类 号：R445.2[医药卫生—影像医学与核医学]