摘要
目的:探讨慢性非特异性腰痛(CNLBP)患者杏仁核亚区的静息态功能连接变化及其与疼痛程度、负性情绪状态的关系。方法:在福建中医药大学屏山校区周边社区招募31例CNLBP患者(CNLBP组)和31名年龄、性别相匹配的健康受试者(健康对照组)进行临床评估及静息态功能磁共振扫描。采用疼痛视觉模拟评分(VAS)评估疼痛程度;采用贝克抑郁量表第2版(BDI-Ⅱ)、贝克焦虑量表(BAI)和恐惧回避信念问卷(FABQ)评估负性情绪状态;采用CONN 20.b软件进行脑影像数据预处理,采用SPM Anatomy 2.2b工具箱选取双侧杏仁核3个亚区[中央内侧核(CM)、基底外侧核(LB)及浅表核(SF)亚区]为感兴趣区,计算受试者的全脑功能连接。分析CNLBP组差异具有统计学意义的脑区功能连接值与临床评估结果的相关性。结果:与健康对照组比较,CNLBP组BDI-Ⅱ、BAI评分均明显更高,差异具有统计学意义(P<0.001)。与健康对照组比较,CNLBP组左侧杏仁核CM亚区与右侧枕下回,左侧杏仁核SF亚区与左侧前扣带回皮层、右侧距状裂周围皮层、左侧丘脑之间的功能连接明显增强(P<0.05),但左侧杏仁核LB亚区与右侧角回,右侧杏仁核SF亚区与右侧海马间的功能连接明显降低(P<0.05)。相关性分析结果显示,CNLBP患者左侧杏仁核SF亚区与左侧前扣带回皮层的功能连接和BDI-Ⅱ评分呈明显正相关关系(P<0.05),右侧杏仁核SF亚区与右侧海马的功能连接和VAS评分呈明显负相关关系(P<0.05)。结论:CNLBP患者表现出以左侧的杏仁核亚区功能连接异常为主的偏侧化现象;杏仁核SF亚区静息态功能连接改变与CNLBP患者的疼痛程度和抑郁情绪具有明显相关性。杏仁核亚区在CNLBP神经病理学机制中可能起重要作用。
Objective:To observe the resting-state functional connectivity changes of amygdalar subregions as well as relationship with pain intensity and negative emotion states in patients with chronic non-specific low back pain(CNLBP).Methods:A total of 31 patients with CNLBP(CNLBP group)and 31 healthy control volunteers(healthy control group)with age and gender matched were recruited from the communities around Pingshan campus of Fujian University of Traditional Chinese Medicine and clinical evaluation and resting-state functional magnetic resonance imaging were performed.Pain visual analog scale(VAS)was used to evaluate pain intensity;Beck depression inventory-Ⅱ(BDI-Ⅱ),Beck anxiety inventory(BAI)and fear avoidance beliefs questionnaires(FABQ)were used to evaluate the negative emotion states;brain imaging data was preprocessed by using CONN 20.b toolbox,three subregions of bilateral amygdala[centromedial(CM),laterobasal(LB)and superficial(SF)areas]were chosen as the regions of interest via using SPM Anatomy 2.2b toolbox,and whole brain functional connectivity was calculated for each subject.The correlations between functional connectivity values of brain regions with significant differences in the CNLBP group and clinical evaluation results were also analyzed.Results:Compared with the healthy control group,the scores of BDI-Ⅱand BAI in CNLBP group were observably higher,and the difference was statistically significant(P<0.001).Compared with the healthy control group,functional connectivity between the left CM amygdala and right inferior occipital gyrus,between the left SF amygdala and left anterior cingulate cortex,right calcarine fissure surrounding cortex and left thalamus in the CNLBP group significantly increased(P<0.05),but functional connectivity between the left LB amygdala and right angular gyrus,between the right SF amygdala and right hippocampus significantly decreased(P<0.05).Correlation analysis demonstrated that functional connectivity of the left SF amygdala and left anterior cingulate cortex was sign
作者
陈晓琳
刘红
高真
吴梦骄
樊城
江征
CHEN Xiaolin;LIU Hong;GAO Zhen;WU Mengjiao;FAN Cheng;JIANG Zheng(College of Rehabilitation Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350122,China;Key Laboratory of Orthopedics&Traumatology of Traditional Chinese Medicine and Rehabilitation,Ministry of Education,Fuzhou,Fu-jian 350122,China;The First Clinical Medical College,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350004,China)
出处
《康复学报》
CSCD
2023年第4期303-309,316,共8页
Rehabilitation Medicine
基金
国家自然科学基金项目(82174523)
福建中医药大学康复技术省部共建协同创新中心项目(X2022014-协同)
关键词
慢性非特异性腰痛
负性情绪
杏仁核
静息态功能连接
磁共振成像
chronic non-specific low back pain
negative emotion
amygdala
resting-state functional connectivity
magnetic resonance imaging
