神经根型颈椎病慢性颈肩痛脑静息态功能连接改变  

Alteration of Functional Connectivity in Patients Suffering From Chronic Neck and Shoulder Pain Caused by Cervical Spondylotic Radiculopathy: A Resting-state fMRI Study

作　　者：徐亚卡[1] 潘君龙[1] 李博[1] 余成新[1] XU Yaka;PAN Junlong;LI Bo(The First Clinical Medical of College China Three Gorges University,Yichang,Hubei Province 443003,P.R.Chin)

机构地区：[1]三峡大学第一临床医学院宜昌市中心人民医院放射科

出　　处：《临床放射学杂志》2018年第7期1082-1086,共5页Journal of Clinical Radiology

摘　　要：目的运用静息态功能磁共振成像（rs-fMRI）功能连接方法研究神经根型颈椎病慢性颈肩痛状态下静息态脑功能改变。方法对25例神经根型颈椎病慢性颈肩痛患者（慢性颈肩痛组）及20例健康志愿者（正常对照组）进行常规磁共振成像、高分辨率3D-T1结构像及静息态功能磁共振扫描。选取前扣带回（ACC）前部（aACC）及前扣带回后部（pACC）作为种子点,组间对比分析全脑其他体素与种子点的功能连接改变。结果与正常对照组相比,慢性颈肩痛组aACC与左侧杏仁核、角回、顶下小叶（IPL）的功能连接减弱;pACC与双侧尾状核及左侧内侧前额叶（mPFC）的功能连接减弱,与左侧枕下回（IOG）、枕上回（SOG）、顶上小叶（SPL）、中央后回（PoCG）及右侧颞中回（MTG）、颞下回（ITG）的功能连接增强（P〈0.01,Alpha Sim矫正,Cluster Size≥18）。结论 ACC的前部和后部与全脑多个脑区的功能连接出现异常,且p ACC与全脑存在异常功能连接的脑区数目更多、分布更广,pACC更多地参与到疼痛处理,是ACC参与疼痛处理的主要次级结构。神经根型颈椎病慢性颈肩痛脑自发性活动异常主要与疼痛感知、认知执行、情感和记忆等脑功能受到影响相关。Objective This study investigates the alterations of spontaneous neural activities of patients with chronic neck and shoulder pain caused by cervical spondylotic radiculopathy（CNSP-CSR） using the method of rs-fMRI. The parameter of the functional connectivity（FC） is counted in this study. Methods CNSP-CSR patients（n = 25） and age-,sex-,and education-matched normal controls（ n = 20） were included in this study. Both conventional MRI,the structural（ high resolution 3D T_1-weight） and rs-fMRI images were acquired. Seed-based whole-brain FC analyses were performed between groups with seed regions placed in the aACC and pACC. Results We found that the aACC had reduced functional connectivity with left amygdala,angular gyrus and IPL. We also found that the pACC had reduced FC with bilateral caudate and left mPFC whereas increased FC with left IOG,SOG,SPL,PoCG and right MTG,ITG. P〈0. 01（ corrected by the Alpha Sim program,cluster size ≥18） were considered to show significant difference between groups. Conclusion The abnormalities of spontaneous brain activity reflected by FC measurement in patients with CNSP-CSR confirm the neuronal disturbances in CNSP. The abnormal FC is mainly associated with pain perception,cognitive execution,emotion and memory effects. The pACC,an important component of ACC,is more involved with pain processing.

关 键 词：神经根型颈椎病 慢性颈肩痛 功能磁共振成像 静息态 功能连接 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.55[医药卫生—诊断学]