原发性舌咽神经痛患者全脑灰质体积变化:基于体素的形态学分析  

Gray matter changes in primary glossopharyngeal neuralgia:a voxel-based morphometry study

作　　者：郑文韬 郝庆沛 吕高泉 刘业祖 武广永 张子豪 刘如恩[1] Zheng Wentao;Hao Qingpei;Lyu Gaoquan;Liu Yezu;Wu Guangyong;Zhang Zihao;Liu Ruen(Department of Neurosurgery,People's Hospital of Peking University,Beijing 100044,China;Department of Neurosurgery,First Affiliated Hospital of Xiamen University,Xiamen 361003,China)

机构地区：[1]北京大学人民医院神经外科,北京100044 [2]厦门大学附属第一医院神经外科,厦门361003

出　　处：《中华神经医学杂志》2023年第12期1220-1228,共9页Chinese Journal of Neuromedicine

摘　　要：目的从脑形态学角度探讨舌咽神经痛(GPN)的潜在中枢发病机制。方法前瞻性选择北京大学人民医院神经外科自2019年4月至2023年6月收治的27例右侧原发性GPN患者(病例组)及同期招募的27例年龄、性别、惯用手、受教育年限与病例组相匹配的健康人群(对照组)为研究对象,并依据术中观察是否存在神经血管压迫将GPN患者分为伴神经血管压迫组(n=18)与不伴神经血管压迫组(n=9)。采用基于Matlab R2017b编程平台的SPM8软件和VBM8工具包处理受试者的全脑高分辨率3D-T1脑结构像数据,分析不同组受试者间各脑区灰质体积的差异。应用Pearson相关性分析评估病例组患者的显著差异脑区灰质体积与其一般资料及疼痛特征的相关性。结果与对照组相比,病例组患者左侧前扣带回、颞中回、颞横回、中央前回、中央后回及右侧岛叶、丘脑、顶下小叶、中央前回、颞中回、颞下回的灰质体积明显减小,差异均有统计学意义(P<0.05,FDR校正)。与伴神经血管压迫组相比,不伴神经血管压迫组患者双侧前扣带回的灰质体积明显减小,差异有统计学意义(P<0.05,FDR校正)。病例组患者的右侧岛叶灰质体积与其病程呈负相关关系(r=-0.521,P=0.005)。结论 GPN患者存在广泛的全脑灰质萎缩现象,其在GPN的发生及维持中可能发挥重要作用。Objective To explore the pathogenesis of glossopharyngeal neuralgia(GPN)in central nervous system from perspective of brain morphology.Methods A prospective study was performed.Twenty-seven patients with right primary GPN admitted to Department of Neurosurgery,People's Hospital of Peking University from April 2019 to June 2023 and 27 healthy subjects(controls)matched with age,gender,dominant hand,and education level during the same period were recruited.These patients were divided into GPN with neurovascular compression group(n=18)and GPN without neurovascular compression(n=9)based on intraoperative presence of neurovascular compression.SPM8 software based on Matlab R2017b programming platform and VBM8 toolbox were used to process the whole-brain high-resolution 3D-T1 brain structural image data of the participants and analyze the differences in the gray matter volume of each brain region between the 2 groups.Pearson correlation was applied to analyze the correlations of gray matter volumes in brain regions enjoying significant difference with baseline data and pain characteristics of these GPN patients.Results Compared with controls,patients with GPN had significantly reduced gray matter volumes in the left anterior cingulate gyrus,middle temporal gyrus,transverse temporal gyrus,precentral gyrus,postcentral gyrus,right insula,thalamus,inferior parietal lobule,precentral gyrus,middle temporal gyrus,and inferior temporal gyrus(P<0.05,FDR corrected).Compared with GPN patients with neurovascular compression,GPN patients without neurovascular compression had significantly reduced gray matter volume in the bilateral anterior cingulate gyrus(P<0.05,FDR corrected).Changes of gray matter volume in the right insula were negatively correlated with disease duration of GPN patients(r=-0.521,P=0.005).Conclusion GPN patients have extensive gray matter atrophy in the brain,which may play an essential role in GPN development and maintenance.

关 键 词：舌咽神经痛 基于体素的形态学分析 灰质体积 

分 类 号：R745[医药卫生—神经病学与精神病学]