腰椎间盘突出症基于低频振幅的脑静息态fMRI研究  

Study on functional magnetic resonance imaging at resting state based on ALFF for lumbar disc herniation

作　　者：张川[1] 胡海[1] 王雪梅[1] 李兵[1] 杨汉丰[1] 徐晓雪[1] 郭志伟 邓婷丹 

机构地区：[1]川北医学院附属医院放射科,四川南充637000 [2]四川省南充市中心医院放射科,四川南充637000 [3]四川省南充市中心医院肿瘤科,四川南充637000

出　　处：《医学影像学杂志》2017年第12期2371-2376,共6页Journal of Medical Imaging

基　　金：四川省教育厅计划项目(编号:112A212)

摘　　要：目的探索静息态下腰椎间盘突出症所致疼痛在脑功能区的反映,及脑区自发神经活动强度与疼痛程度的相关性,探索腰椎间盘突出症疼痛的脑机制。方法采用3.0T磁共振扫描仪,对13名腰椎间盘突出症患者(lumbar disc herniation,LDH组)及对照组(health control group,HC组)13名健康人群进行静息态功能磁共振扫描,扫描后的图像采用基于MATLAB 2010平台的SPM 8及REST 1.8处理。1)计算低频振幅(amplitude of low frequency fluctuations,ALFF)并比较LDH组与HC组脑区变化的差异;2)将ALFF有显著性差异的所有脑区选为感兴趣区,以信号峰值坐标为中心提取感兴趣区内ALFF平均值,对感兴趣区ALFF平均值与LDH组患者视觉模拟评分(visual analog scale,VAS)进行相关分析。结果 1)与HC组相比,LDH组患者右侧初级感觉/运动皮层(primary sensory/motor cortex,S1/M1)、右额下回、右颞上回、右颞下回/梭状回、左颞下回/梭状回、左海马旁回ALFF值显著增高,P<0.05,K>40,未校正;而PCC、左岛叶、双侧基底节、双侧前额叶中部、右缘上回/颞中回、左小脑后叶ALFF值明显减低,P<0.05,K>40,未校正;2)VAS评分与右侧S1/M1、PCC、左侧岛叶、左侧基底节、右侧基底节、右侧颞下回/梭状回ALFF平均值呈正相关,相关系数R分别为0.612、0.621、0.662、0.468、0.677、0.580,P<0.05。结论 LDH所致疼痛引起广泛的脑功能区ALFF的异常,涉及疼痛感觉、运动、情绪及记忆、认知等多个维度。右侧S1/M1、PCC、左侧岛叶、双侧基底节、右侧颞下回/梭状回ALFF平均值与疼痛程度存在正相关性,提示可能通过上述脑区自发神经活动的强度客观反映患者疼痛程度。Objective To investigate alteration in cerebral functional areas and the correlation between the intensity of spontaneous neural activity and pain intensity in lumbar disc herniation（ LDH） patient at rest in order to provide further insight into brain mechanisms during pain. Methods 13 patients with generalized lumbar disc herniation and 13 healthy controls（ HC） were recruited for this study. A 3. 0 T scanner was used to generate images of brain which were dealed with SPM8 statistical package based on MATLAB 2010. 1） Amplitude of low frequency fluctuations（ ALFF） was obtained to compare the difference in brain regions between the LDH and HC group; 2） In LDH group,the correlation between the average value of ALFF in ROIs and visual analog scale（ VAS） of pain was analyzed. Results 1） Compared to in HC group,higher ALFF value in LDH goup was noted in areas of Primary sensory/motor cortex（ S1/M1）,inferior frontal,superior temporal and inferior temporal/fusiform gyri of the right side,and superior temporal/fusiform and parahippocampal gyri of the left side whereas lower ALFF value in LDH goup was noted in PCC,left insula and bilateral basal ganglia,bilateral medial prefrontal cortex,right supramarginal/middle temporal gyri and left cerebellar lobe,P〈0. 05,K 40; 2） Positive correlation between the average ALFF and VAS was noted at right frontal gyri,PCC,left insula,bilateral basal ganglia,right inferior temporal/fusiform gyri,the correlation coefficients R were 0. 612,0. 621,0. 662,0. 468,0. 677,0. 580,P〈0. 05. Conclusion ALFF abnormalities caused by pain in LDH involve in a wide range of brain functional areas of pain perception,movement,emotion and memory,cognitive. Positive correlation between the average ALFF at right S1/M1,PCC,left insula,bilateral basal ganglia,right inferior temporal/fusiform gyri and VAS in LDH,suggest that ALFF perhaps can be used as a parameter of pain intensity,objectively.

关 键 词：腰椎间盘突出症 疼痛 磁共振成像 低频振幅 

分 类 号：R445.2[医药卫生—影像医学与核医学] R741.04[医药卫生—诊断学]