膝骨性关节炎患者伏隔核功能连接特征的fMRI研究  

fMRI Study on the Functional Connectivity of Nucleus Accumbens in Patients with Knee Osteoarthritis

作　　者：肖阳 刘娇[1,2] 胡坤 林梅琴[1] 涂幼雪[1] 陶静 陈立典[1] 黄佳[1] XIAO Yang;LIU Jiao;HU Kun;LIN Meiqin;TU Youxue;TAO Jing;CHEN Lidian;HUANG Jia(College of Rehabilitation Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350122,China;Fujian Provincial Rehabilitation Engineering Research Center,Fuzhou,Fujian 350122,China)

机构地区：[1]福建中医药大学康复医学院,福建福州350122 [2]福建省康复技术工程研究中心,福建福州350122

出　　处：《康复学报》2020年第1期40-45,共6页Rehabilitation Medicine

基　　金：国家自然科学基金项目(81904270);福建省教育厅高校杰出青年科研人才培育计划项目(闽教科〔2018〕47号);福建中医药大学协同创新中心课题项目(X2012001-协同)。

摘　　要：目的:分析膝骨性关节炎(KOA)患者伏隔核(NAc)静息态功能连接与健康受试者的差异,探讨KOA患者NAc功能网络的变化特点,分析KOA疼痛发生的可能机制。方法:本研究招募福建省福州市各社区KOA患者16例作为KOA组,以及与其年龄和性别相匹配的16例健康受试者作为健康对照组。首先进行一般临床资料、行为学数据的采集,包括性别、年龄、简明疼痛评定量表(BPI)评分等;KOA组还需进行膝关节损伤与骨关节炎评分量表(KOOS)疼痛分测验评估疼痛程度。2组一般资料和行为学资料评估完成后1周内进行静息态功能核磁共振成像(rs-fMRI)和结构像核磁扫描,使用CONN18b软件包对fMRI数据进行预处理,采用加拿大蒙特利尔神经科学研究所(MNI)的AAL模板双侧NAc作为感兴趣区,分析2组受试者双侧NAc与全脑体素功能连接的差异,并与KOOS疼痛分测验评分进行相关性分析。结果:KOA患者与健康受试者一般资料(年龄、性别)匹配,健康受试者BPI评分为0分;2组受试者双侧伏隔核与全脑体素功能连接分析,与健康受试者相比,KOA患者双侧NAc与双侧前扣带回、左侧尾状核和右侧颞极功能连接增强;与健康受试者相比,KOA患者双侧NAc与右侧背外侧前额叶、左侧次感觉区、双侧角回功能连接减弱。2组受试者双侧NAc功能连接差异的脑区与KOOS疼痛分测验评分相关性分析,KOA患者组中NAc与右侧背外侧前额叶及左侧次感觉区功能连接改变与KOOS疼痛分测验评分正相关。结论:中枢多巴胺系统相关脑区NAc与认知控制、情绪调节、感觉加工相关脑区及默认网络功能连接的异常可能是KOA患者疼痛发生的机制之一。Objective:To explore the underlying mechanism of pain syndrome in patients with knee osteoarthritis(KOA)via comparing the resting state functional connectivity(rs-FC)group difference of nucleus accumbens(NAc)between patients with KOA and healthy controls.Methods:A total of 16 KOA patients were enrolled as the KOA group,and 16 healthy controls were enrolled as the healthy control group.All of those subjects were enrolled from various communities in Fuzhou city,Fujian province.Firstly,all subjects'general and behavioral data,including gender,age,and the brief pain inventory(BPI)score,were collected.The KOA group also used the knee injury and osteoarthritis outcome score(KOOS)to assess pain intensity,and functional magnetic resonance imaging(fMRI)data were preprocessed using the CONN18b software package,resting-state fMRI(rs-fMRI)and structural MRI were performed within one week after completed the general and behaviourl data assessment for the two groups.Pre-processing of fMRI data was performed via using a pipeline in CONN18b toolbox.Our study used the AAL template NAc of the Montreal Neuroscience Institute(MNI)as the region of interest to analyze the differences in the functional connectivity between the NAc and the whole brain voxels in the two groups of subjects and its correlation with the KOOS.Results:The general data(age,gender)of the KOA group were matched with the healthy control group,and the BPI score of the healthy control group was 0.Functional connectivity between bilateral nucleus accumbens and whole brain volume were analyzed in the two groups.Compared to the healthy control group,increased rsFC was found between bilateral NAc and bilateral anterior cingulate cortex,the left caudate and the right temporal pole.Our study also found significantly decreased rsFC between bilateral NAc and the right dorsolateral prefrontal cortex(DLPFC),the left secondary sensory area(S2)and bilateral angular gyrus.About the correlation between brain regions with differences in functional connectivity of bilateral NAc an

关 键 词：膝骨性关节炎 疼痛 静息态功能核磁共振成像 伏隔核 

分 类 号：R684.3[医药卫生—骨科学] R445.2[医药卫生—外科学]