神经根型颈椎病颈肩痛脑静息态局部一致性研究  

Regional homogeneity of brain 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 Ya-ka;PAN Jun-long;LI Bo(The First Clinical Medical of College China Three Gorges University,Hubei 443003,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,湖北443003

出　　处：《放射学实践》2018年第6期549-554,共6页Radiologic Practice

摘　　要：目的:运用静息态功能磁共振成像(rs-fMRI)局部一致性(ReHo)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:采用Philips公司Achieva 3.0TTX多射频源超导磁共振扫描仪对25例神经根型颈椎病慢性颈肩痛患者及20例健康志愿者进行常规磁共振、高分辨率3DT1结构像及静息态功能磁共振扫描,扫描结束对每位患者进行视觉模拟评分(VAS)。组间对比分析ReHo的改变,并对ReHo均值与VAS得分进行Pearson相关性分析。结果:与正常对照组相比,神经根型颈椎病慢性颈肩痛组ReHo值减低的脑区位于左侧岛叶(IC)、海马(Hip)、辅助运动区(SMA)、额上回(SFG),右侧中央后回(PoCG)、顶上小叶(SPL);ReHo值增高的脑区位于双侧额中回(MFG)(P<0.01,AlphaSim矫正,Cluster Size≥18)。神经根型颈椎病慢性颈肩痛组左侧IC的ReHo均值与VAS得分存在显著负相关性(r=-0.552,P=0.004)。结论:神经根型颈椎病慢性颈肩痛导致以额、顶叶为主的部分脑区出现ReHo的异常改变。左侧IC能够感知疼痛强度。神经根型颈椎病慢性颈肩痛脑自发性活动异常主要与认知执行和情感、疼痛感知及记忆等脑功能受到影响相关。Objective：To investigate 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 resting-state functional magnetic resonance imaging（rs-fMRI）.The regional homogeneity of brain（ReHo）is counted for between-group comparisons.Methods：CNSP-CSR patients（n=25）and age-,sex-,and education-matched normal controls（n=20）were included in this study.Both traditional MRI,the structural（high resolution 3 D T1-weighted）and rs-fMRI images were acquired by Philips Achieva 3.0 TTX.The visual analgesia score（VAS）was conducted for assessment of pain intensity after scans.ReHo was used for functional images analysis and a Pearson＇s correlation analysis was performed between VAS scores and mean ReHo values of brain regions.Results：We found significantly decreased ReHo values in left insular cortex（IC）/hippocampus（Hip）/supplementary motor area（SMA）/superior frontal gyrus（SFG）,right postcentral gyrus（PoCG）/superior parietal lobe（SPL）,while increased ReHo values in the bilateral middle frontal gyrus（MFG）between patient and control groups.P〈0.01（corrected by the AlphaSim program,cluster size≥18）was considered to show significant difference between groups.The mean ReHo values had a significant negative correlation（r=-0.552,P=0.004）with VAS scores in the left IC,none of the other significant correlations were found.Conclusion：The abnormalities of spontaneous brain activity reflected by ReHo measurement in CNSP-CSR patients confirm the neuronal disturbances in CNSP and the association with cognitive and executive function,emotion,pain processing and memory.The left IC is associated with pain perception.The pACC,an important component of ACC,is more involved in pain perception.

关 键 词：颈椎病 磁共振成像 大脑 

分 类 号：R445.2[医药卫生—影像医学与核医学] R322.81[医药卫生—诊断学]