摘要
目的使用种子点相关性方法探讨椎间盘突出所致的慢性腰腿痛患者岛叶功能连接的改变特点及其在疼痛感知中的可能机制。方法使用3.0 T磁共振成像仪分别采集慢性腰腿痛患者(n=22)和对照组(n=24)的静息态功能MRI数据,经预处理后,采用基于种子点(左侧岛叶坐标:-38,-6,5,半径6 mm;右侧岛叶坐标:35,-11,6,半径6 mm)相关性方法进行功能连接分析。组间比较岛叶功能连接显著差异脑区,并提取其功能连接系数与临床评估(日本骨科协会评分、视觉模拟量表评分、Barthel指数计分法和感觉评估等)参数进行偏相关分析。结果和健康对照组比较,慢性腰腿痛患者组左侧岛叶功能连接显著增高的脑区主要位于右侧壳核、左侧额下回,功能连接显著减低的脑区主要位于双侧额内侧回;患者组右侧岛叶显著减低的脑区主要位于双侧直回(体素水平P<0.01,高斯随机场理论校正,簇水平P<0.05)。在慢性腰腿痛患者组,左侧岛叶与左侧额下回的功能连接系数与视觉模拟量表评分呈正相关(ρ=0.521,P=0.026)。岛叶与其他相关脑区的功能连接系数与患者病程、日本骨科协会评分、视觉模拟量表评分、Barthel评分等临床参数未显示明显相关。结论慢性腰腿痛患者存在岛叶功能连接异常,这可能和疼痛刺激有关。
Objective Using seed-based correlation analysis in patients with chronic low back-related leg pain(LBLP)to examine the alterations of the functional connectivity of insular and its possible mechanisms of pain perception.Methods Using 3.0 T MRI system to collect the resting-state functional MRI date of patients with LBLP and age-and sex-matched healthy control subjects(HCs).After data-preprocessed,functional connectivity analysis was carried out by using correlation analysis based on the seed region(left insular:-38,-6,5,r=6 mm;right insular:35,-11,6,r=6 mm),and group comparison was performed in the significant different brain regions.Then extract the regions with altered connectivity coefficient and clinic evaluation such as Japanese Orthopaedic Association(JOA),visual analogue scale(VAS),the Barthel index of ADL for the use of partial correlation statistical analyses.Results Compared with HCs Group(n=24),LBLP patients(n=22)showed increased functional connectivity between left insular and right putamen and left inferior frontal gyrus,decreased functional connectivity between left insular and bilateral medial frontal gyrus;And they also exhibited decreased functional connectivity between right insular and bilateral rectus(voxel-level<0.01,Gaussian random field theory correction,cluster level P<0.05).In LBLP Group,the functional connectivity coefficient between left insular and left inferior frontal gyrus showed significant positive correlation with VAS(P=0.521,P=0.026).In addition,the functional connectivity coefficient between insular and other related brain regions did not show significant correlation with clinical parameters such as duration of disease,Barthel,VAS and JOA.Conclusion This study confirmed that patients with chronic low back-related leg pain have abnormal insular functional connectivity,which may be involved in pain stimulation.
作者
刘涵静
邓钰
周福庆
LIU Hanjing;DENG Yu;ZHOU Fuqing(Department of Radiology,First Affiliated Hospital,Nanchang University,Nanchang,Jiangxi Province 330006,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2019年第11期2015-2020,共6页
Journal of Clinical Radiology
关键词
功能连接
慢性腰腿痛
椎间盘突出
岛叶
静息态功能磁共振成像
Functional connectivity
Chronic low back-related leg pain
Herniated disk
Insular
Resting-state fMRI
