肉毒毒素治疗局灶型肌张力障碍中枢神经系统机制的影像学研究进展  

A progress in neuroimaging research on the central mechanisms of botulinum toxin in the treatment of focal dystonia

作　　者：穆秦颖 胡俊豪 马福浩 王浩[1] 窦炜康 迟丽屹[3] 史明 MU Qinying;HU Junhao;MA Fuhao;WANG Hao;DOU Weikang;CHI Liyi;SHI Ming(Department of Neurology,Xijing Hospital,Air Force Medical University,Xi’an 710032,China)

机构地区：[1]中国人民解放军空军军医大学西京医院神经内科,西安710032 [2]中国人民解放军联勤保障部队第987医院神经内科 [3]中国人民解放军联勤保障部队第986医院神经内科

出　　处：《中国神经精神疾病杂志》2024年第7期440-444,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金项目(编号:82071464);陕西省卫生健康科研项目(编号:2022B005);西京创新研究院-联合创新基金(编号:LHJJ24JC10)。

摘　　要：肉毒毒素(botulinum toxin,BoNT)是目前治疗局灶型肌张力障碍的一线方法,其机制为化学性去神经支配引起肌肉麻痹。近期神经影像学研究发现,BoNT亦可影响肌张力障碍患者脑内的神经可塑性,但具体的中枢神经系统机制尚未完全阐明。本文从功能磁共振成像、结构磁共振成像、正电子发射断层成像3个方面,对BoNT可能的中枢神经系统作用机制进行综述,揭示了BoNT可通过影响皮质、基底神经节、丘脑、小脑等脑区的功能连接、微观结构、代谢水平,以改善肌张力障碍患者的症状,为进一步探索肌张力障碍的发生机制和研发潜在的干预靶点提供理论参考。Botulinum toxin(BoNT)is currently the first-line method for treating focal dystonia,which causes muscle paralysis by chemical denervation.Recent neuroimaging studies have found that BoNT treatment could alter neuroplasticity in the brain of patients with focal dystonia.However,the specific central nervous system mechanisms have not been fully elucidated.To this end,here we review the neuroimaging studies on BoNT treatment for dystonia from three aspects:functional magnetic resonance imaging,structural magnetic resonance imaging,and positron emission tomography imaging.It suggests that BoNT may improve the symptoms of dystonia patients by affecting functional connectivity,microstructure,and metabolic levels of the cortex,basal ganglia,thalamus,and cerebellum,etc.Therefore,this review will provide a theoretical reference for further exploring the mechanism and developing potential therapeutic targets of dystonia.

关 键 词：肌张力障碍 肉毒杆菌毒素 中枢神经系统 神经网络 神经可塑性 磁共振成像 正电子发射断层成像 

分 类 号：R746[医药卫生—神经病学与精神病学]