经典型三叉神经痛患者海马结构与功能的功能MRI研究  

Alteration of Structure and Function Within Hippocampus in Classical Trigeminal Neuralgia:A fMRI Study

作　　者：欧阳涛 彭新级 何来昌[1] 钟军[1] 谭永明[1] OUYANG Tao;PENG Xinji;HE Laichang(Department of Radiology,the First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi Province 330006,P.R.China)

机构地区：[1]南昌大学第一附属医院影像科

出　　处：《临床放射学杂志》2019年第10期1806-1810,共5页Journal of Clinical Radiology

基　　金：国家自然基金项目(编号:81101041);江西省自然科学基金项目(编号:20181BAB205063)

摘　　要：目的利用扩散张量成像(DTI)及静息态功能磁共振成像(rs-fMRI)技术观测经典型三叉神经痛(CTN)患者海马区表观扩散系数(ADC)、各向异性分数(FA)和低频振幅(ALFF)的变化,探究其神经病理性疼痛患者记忆等相关认知功能改变的可能机制。方法 27例CTN患者与27例年龄、性别与之相匹配的健康志愿者接受神经心理学及疼痛评估和DTI、fMRI扫描,将海马作为感兴趣区,对两组间海马ALFF、ADC、FA值进行两独立样本t检验分析,并分析CTN组内ALFF、ADC、FA值和简易智能精神状态检查量表(MMSE)、痛觉视觉模拟评分(VAS)、临床痴呆评定(CDR)临床评分之间的相关性。结果与健康对照组比较,CTN患者右侧海马FA显著升高(t=2.387,P=0.021)及右侧海马头部ALFF明显升高(P<0.05,GRF校正,体素>10)。CTN组右侧海马头部异常脑区ALFF值与MMSE评分存在正性相关(r=0.835,P=0.000)。结论 CTN患者存在海马区结构及功能异常,可能是患者记忆、情感及认知改变的原因。Objective Applying Diffusion Tensor Imaging(DTI)and resting-state functional Magnetic Resonance Imaging(rs-fMRI)to speculate the possible mechanisms of related cognitive function(such as memory)alterations in patients with classical trigeminal neuralgia(CTN)by observing Apparent Diffusion Coefficient(ADC),Fractional Anisotropy(FA)and Amplitude of Low Frequency Fluctuation(ALFF)within the hippocampus.Methods Neuropsychology and pain assessment,DTI and rs-fMRI scanning were applied to 27 patients with CTN and 27 healthy volunteers(same age,same sex and same degree of education).Hippocampus was regarded as ROI and then ALFF、ADC、FA values were then calculated and compared between CTN and healthy group by two independent samples t-test.For CTN group,Pearson correlation was performed to analyse ALFF、ADC、FA value correlation with MMSE,VAS,CDR.Results Compared with the healthy group,CTN group shows significantly increased FA(t=2.387,P=0.021)and increased ALFF in the hippocampal head(P<0.05,voxel>10,GRF correction).There was a positive correlation between MMSE scores and ALFF values of right hippocampal head in CTN(r=0.835,P=0.000).Conclusion CTN demonstrated abnormality of structures and functions in the hippocampus,which may explain why memory,emotion or cognition changed.

关 键 词：经典型三叉神经痛 海马 扩散张量成像 低频振幅 

分 类 号：R74[医药卫生—神经病学与精神病学]