前庭性偏头痛神经通路的功能性核磁研究  

The fMRI research of vestibular migraine neural pathways

作　　者：于焕新[1] 李海艳[1] 印志娴[1] 张金玲[1] 刘钢[1] 

机构地区：[1]天津市环湖医院耳鼻咽喉头颈外科,天津300350

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第12期906-909,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探索前庭性偏头痛(VM)患者的异常神经通路,并定位其功能区,以推断其可能的发病机制。方法:对VM组(20例)、无先兆的偏头痛(MwoA)组(20例)和健康对照组(20例)分别进行冷水灌耳试验,选择刺激时以及刺激间歇期的全脑血氧饱和度依赖的功能核磁共振成像(BOLD fMRI),获取VM组、MwoA组及健康对照组的激活区,进行组间对比。结果:所有试验对象冷水灌耳试验后,多处皮层及皮层下区域激活,顶叶、颞叶、岛叶皮质、扣带回、丘脑、尾状核区、视辐射、楔前叶均观察到BOLD信号明显改变。对比发现VM患者的丘脑背内外侧核区正激活,枕颞内侧回皮质负激活(P<0.05)。结论:fMRI能较客观清晰地反应脑部各功能区活动情况;VM患者发病机制为丘脑背内外侧区及枕颞内侧回皮质异常激活,在前庭感觉通路传递过程中与痛觉通路产生交叉。Objective： To investigate the abnormal functional response of neural pathways of vestibular mi- graine （VM） patients,located the functional area, and inferred the possible mechanism. Method：Twenty patients of VM,20 of migraine without aura（MwoA）, and 20 of healthy controls（HC）, underwent whole-brain blood oxygen level-dependent（BOLD） fMRI during ear irrigation with cold water. We chose the stimulation image and the dia- pause stimulation image. Analyses explored functional area with BOLD signal change of the three groups. Result： We observed task-positive BOLD signal change in cortical and subcortical pattern in response to ear irrigation of all participants. Such as parietal lobe, temporal lobe, insular lobe, cingulate gyrus, thalamus, caudate nucleus, optic ra diation,precuneus. VM patients showed a significantly task-negativen in thalamic and fusiform gyrus in compari- son with the other groups（P〈0.05）. Conclusion： fMRI could response the respective functional area objectively. We inferred the possible mechanism of VM was abnormal activation of thalamus and fusiform gyrus, produced crossing between the vestibular sensory pathway conduction and the Pain conduction

关 键 词：前庭性偏头痛 功能性核磁共振 脑功能区 

分 类 号：R747.2[医药卫生—神经病学与精神病学]