摘要
目的基于图论的方法探讨原发性三叉神经痛（ITN）患者脑功能属性的改变。方法选择华中科技大学同济医学院附属同济医院神经内科或神经外科自2013年5月至2015年1月收治的左侧ITN患者20例（ITN组1并同期招募年龄、性别与ITN组相匹配的健康志愿者22例（健康对照组）。采集2组受试者的功能性磁共振成像（伽RJ）数据，使用GRETNA软件进行脑网络分析，比较全脑网络特征、脑区节点特征（全局效率、局部效率、聚类系数、特征路径长度、“小世界”特性）的改变；采用基于网络的分析（NBS）比较大脑环路功能连接的改变。采用Pearson相关性分析ITN患者脑功能属性与临床指标的相关性。结果与健康对照组比较，ITN组患者右侧踞状裂周围皮层（CALl及双侧丘脑（THA）的聚类系数增高，右侧顶上小叶（SPLl的路径长度减小，左侧额上N（SFG）的全局效率增高，右侧SFG、右侧CAL、双侧楔叶（CUN）、左侧苍白球（PAL）的局部效率增高，差异均有统计学意义（P〈0．05）；ITN患者左侧SFG的全局效率、右侧SFG的局部效率均与病程呈负相关关系（r=-0．500，P=-0．035；r=-0．501，P=-0．034）；NBS分析显示：与健康对照组比较，ITN组患者左SFG．右辅助运动区（SMA）、左SFG-右SFG、左SFG-右额中回（MFG）、左SFG-右额中回眶部（ORBmid）、左SFG-右额下回岛盖部（IFGoperc）、左SFG-双侧壳核（PUT）、左SFG-右PAL、右PUT-左内侧额上回（SFGmed）、左PUT-右尾状核（CAU）的功能环路连接增强。ITN患者左SFG-右IFGoperc功能连接强度与病程呈负相关关系（r=-0．487，P=-0．041）。结论ITN患者脑区节点的功能连接发生显著变化，与前额叶相关的功能环路连接显著增强，可能暗示了ITN患者对痛觉的高度敏感性及调节。
Objective To discuss the alterations of functional brain properties in patients with idiopathic trigeminal neuralgia （ITN） based on graph theoretical approaches. Methods A total of 20 patients with pain in the distribution of left trigeminal nerve and 22 matched healthy controls were recruited in our hospital from May 2013 to January 2015. Resting-state functional MRI data in both groups were collected and analyzed with GRETNA software to obtain the matrices of brain network. From these connectivity matrices, a number of key characteristics were computed, including network efficiency, weighted shortest path length, weighted clustering coefficient and small-wordless. A two-tailed t test was used to appraise the significance of any inter-group differences in complex network measures investigated. Network-based statistic （NBS） approach was used to localize specific pairs of brain regions in which functional connectivity strength were altered in patients. Pearson＇s correlation analyses were performed to identify the correlations between clinical data and altered network properties in patients. Results ITN patients had significantly increased weighted clustering coefficient in the fight calcarine （CAL） and bilateral thalamus, increased total efficiency in the left superior frontal gyrus （SFG）, and increased regional efficiency in the right SFG, right CAL, bilateral cuneus and left pallidum,and significantly reduced weighted shortest path length for regional nodal characteristics in the right superior parietalis lobules （P〈0.05）. The total efficiency in the left SFG and regional efficiency in the right SFG in ITN patients were negatively correlated with course of disease （r=-0.500, P=0.035; r=- 0.501, P=-0.034）. As compared with the healthy controls, the ITN patients had enhanced fimctional loop connection between left SFG and right supplementary motor area, between left SFG and right SFG, between left SFG and right middle frontal gyrus, between left SFG and right orbital middle frontal gyru
出处
《中华神经医学杂志》
CSCD
北大核心
2017年第9期865-870,共6页
Chinese Journal of Neuromedicine
基金
国家自然科学基金（81171308、81570462）
关键词
原发性三叉神经痛
图论
静息态功能磁共振成像
脑网络
Idiopathic trigeminal neuralgia
Graph theory
Resting-state functional magnetic resonance imaging
Brain network
