Hepatic myelopathy is a complication seen in patients with chronic liver failure with physiologic or iatrogenic portosystemic shunting. The main symptom is progressive lower limb dyskinesia. The role of the brain moto...Hepatic myelopathy is a complication seen in patients with chronic liver failure with physiologic or iatrogenic portosystemic shunting. The main symptom is progressive lower limb dyskinesia. The role of the brain motor control center in hepatic myelopathy is unknown. This study aimed to investigate the gray matter changes in patients with hepatic myelopathy secondary to transjugular intrahepatic portosystemic shunt and to examine their clinical relevance. This was a cross-sectional study. Twenty-three liver failure patients with hepatic myelopathy(hepatic myelopathy group), 23 liver failure patients without hepatic myelopathy(non-hepatic myelopathy group) after transjugular intrahepatic portosystemic shunt, and 23 demographically matched healthy volunteers were enrolled from March 2014 to November 2016 at Xijing Hospital, Air Force Military Medical University(Fourth Military Medical University), China. High-resolution magnetization-prepared rapid gradient-echo brain imaging was acquired. Group differences in regional gray matter were assessed using voxel-based morphometry analysis. The relationship between aberrant gray matter and motor characteristics was investigated. Results demonstrated that compared with the non-hepatic myelopathy group, gray matter volume abnormalities were asymmetric, with decreased volume in the left insula(P = 0.003), left thalamus(P = 0.029), left superior frontal gyrus(P = 0.006), and right middle cingulate cortex(P = 0.021), and increased volume in the right caudate nucleus(P = 0.017), corrected with open-source software. The volume of the right caudate nucleus in the hepatic myelopathy group negatively correlated with the lower limb clinical rating of the Fugl-Meyer Assessment(r = –0.53, P = 0.01). Compared with healthy controls, patients with and without hepatic myelopathy exhibited overall increased gray matter volume in both thalami, and decreased gray matter volume in both putamen, as well as in the globus pallidus, cerebellum, and vermis. The gray matter abnormalities we found展开更多
目的应用基于体素磁共振形态测量(Voxel based morhometry,VBM)研究腰椎间盘突出(Lumbar disc herniation,LDH)患者慢性期疼痛使脑结构发生改变的区域。方法搜集新乡医学院第二附属医院已确诊为腰间盘突出且疼痛持续时间超过3个月患者5...目的应用基于体素磁共振形态测量(Voxel based morhometry,VBM)研究腰椎间盘突出(Lumbar disc herniation,LDH)患者慢性期疼痛使脑结构发生改变的区域。方法搜集新乡医学院第二附属医院已确诊为腰间盘突出且疼痛持续时间超过3个月患者58名为病例组(LDH组),62名健康志愿者为正常对照组(HC组),利用西门子3.0T核磁共振对120名受试者进行3DT1结构成像,然后使用SPM-VBM软件对采集的磁共振数据进行分析,最后采用REST软件包进行统计学分析。结果与HC组相比,LDH患者在右侧扣带回、左额叶、左颞上回、左顶下小叶等区域的白质(WM)体积存在差异(FDR校正,P<0.05);在右小脑前叶、右中央前回、右小脑后叶、左梭状回、左额上回、右尾状核、右额中回、左颞中回、右扣带回等区域的灰质(GM)体积存在差异性(FDR校正,P<0.05)。结论利用VBM软件能够发现LDH慢性期疼痛患者脑灰质和白质存在差异的区域,可以为临床治疗和预后提供有效的价值。展开更多
目的 :利用基于体素的形态测量学(voxel-based mor phometry,VBM)方法,探讨肝豆状核变性(Wilson’s disease,WD)患者全脑灰质结构变化特点。方法 :采集30例WD患者(WD组)及30例健康志愿者(对照组)的大脑3.0 T MRI高分辨力T1WI图像,通过FS...目的 :利用基于体素的形态测量学(voxel-based mor phometry,VBM)方法,探讨肝豆状核变性(Wilson’s disease,WD)患者全脑灰质结构变化特点。方法 :采集30例WD患者(WD组)及30例健康志愿者(对照组)的大脑3.0 T MRI高分辨力T1WI图像,通过FSL-VBM软件进行数据预处理后,利用AFNI软件行双样本t检验,比较2组全脑灰质体积差异,运算结果经FDR校正(P=0.001,α<0.05)。结果 :WD组与对照组比较,双侧的尾状核、苍白球、丘脑背内侧核、小脑半球、中央前后回、岛叶、额中回,脑桥基底部,左侧的后扣带回及丘脑枕灰质体积萎缩;双侧的岛叶及胼胝体,右侧的颞上回、额上回、红核,左侧的颞中回、额内侧回存在灰质体积增生。结论:WD患者灰质核团及大脑皮层存在广泛灰质体积萎缩,而部分皮层区域及少数灰质核团存在灰质体积增生;灰质异常脑区对解释其临床症状具有重要意义。展开更多
A reduction in gray matter volume is common in patients with chronic back pain, and different types of pain are associated with gray matter abnormalities in distinct brain regions. To examine differ- ences in brain mo...A reduction in gray matter volume is common in patients with chronic back pain, and different types of pain are associated with gray matter abnormalities in distinct brain regions. To examine differ- ences in brain morphology in patients with low back pain or neck and upper back pain, we investi- gated changes in gray matter volume in chronic back pain patients having different sites of pain using voxel-based morphometry. A reduction in cortical gray matter volume was found primarily in the left postcentral gyrus and in the left precuneus and bilateral cuneal cortex of patients with low back pain. In these patients, there was an increase in subcortical gray matter volume in the bilateral putamen and accumbens, right pallidum, right caudate nucleus, and left amygdala. In upper back pain patients, reduced cortical gray matter volume was found in the left precentral and left postcen- tral cortices. Our findings suggest that regional gray matter volume abnormalities in low back pain patients are more extensive than in upper back pain patients. Subcortical gray matter volume in- creases are found only in patients with low back pain.展开更多
文摘Hepatic myelopathy is a complication seen in patients with chronic liver failure with physiologic or iatrogenic portosystemic shunting. The main symptom is progressive lower limb dyskinesia. The role of the brain motor control center in hepatic myelopathy is unknown. This study aimed to investigate the gray matter changes in patients with hepatic myelopathy secondary to transjugular intrahepatic portosystemic shunt and to examine their clinical relevance. This was a cross-sectional study. Twenty-three liver failure patients with hepatic myelopathy(hepatic myelopathy group), 23 liver failure patients without hepatic myelopathy(non-hepatic myelopathy group) after transjugular intrahepatic portosystemic shunt, and 23 demographically matched healthy volunteers were enrolled from March 2014 to November 2016 at Xijing Hospital, Air Force Military Medical University(Fourth Military Medical University), China. High-resolution magnetization-prepared rapid gradient-echo brain imaging was acquired. Group differences in regional gray matter were assessed using voxel-based morphometry analysis. The relationship between aberrant gray matter and motor characteristics was investigated. Results demonstrated that compared with the non-hepatic myelopathy group, gray matter volume abnormalities were asymmetric, with decreased volume in the left insula(P = 0.003), left thalamus(P = 0.029), left superior frontal gyrus(P = 0.006), and right middle cingulate cortex(P = 0.021), and increased volume in the right caudate nucleus(P = 0.017), corrected with open-source software. The volume of the right caudate nucleus in the hepatic myelopathy group negatively correlated with the lower limb clinical rating of the Fugl-Meyer Assessment(r = –0.53, P = 0.01). Compared with healthy controls, patients with and without hepatic myelopathy exhibited overall increased gray matter volume in both thalami, and decreased gray matter volume in both putamen, as well as in the globus pallidus, cerebellum, and vermis. The gray matter abnormalities we found
文摘目的应用基于体素磁共振形态测量(Voxel based morhometry,VBM)研究腰椎间盘突出(Lumbar disc herniation,LDH)患者慢性期疼痛使脑结构发生改变的区域。方法搜集新乡医学院第二附属医院已确诊为腰间盘突出且疼痛持续时间超过3个月患者58名为病例组(LDH组),62名健康志愿者为正常对照组(HC组),利用西门子3.0T核磁共振对120名受试者进行3DT1结构成像,然后使用SPM-VBM软件对采集的磁共振数据进行分析,最后采用REST软件包进行统计学分析。结果与HC组相比,LDH患者在右侧扣带回、左额叶、左颞上回、左顶下小叶等区域的白质(WM)体积存在差异(FDR校正,P<0.05);在右小脑前叶、右中央前回、右小脑后叶、左梭状回、左额上回、右尾状核、右额中回、左颞中回、右扣带回等区域的灰质(GM)体积存在差异性(FDR校正,P<0.05)。结论利用VBM软件能够发现LDH慢性期疼痛患者脑灰质和白质存在差异的区域,可以为临床治疗和预后提供有效的价值。
文摘目的 :利用基于体素的形态测量学(voxel-based mor phometry,VBM)方法,探讨肝豆状核变性(Wilson’s disease,WD)患者全脑灰质结构变化特点。方法 :采集30例WD患者(WD组)及30例健康志愿者(对照组)的大脑3.0 T MRI高分辨力T1WI图像,通过FSL-VBM软件进行数据预处理后,利用AFNI软件行双样本t检验,比较2组全脑灰质体积差异,运算结果经FDR校正(P=0.001,α<0.05)。结果 :WD组与对照组比较,双侧的尾状核、苍白球、丘脑背内侧核、小脑半球、中央前后回、岛叶、额中回,脑桥基底部,左侧的后扣带回及丘脑枕灰质体积萎缩;双侧的岛叶及胼胝体,右侧的颞上回、额上回、红核,左侧的颞中回、额内侧回存在灰质体积增生。结论:WD患者灰质核团及大脑皮层存在广泛灰质体积萎缩,而部分皮层区域及少数灰质核团存在灰质体积增生;灰质异常脑区对解释其临床症状具有重要意义。
基金supported partially by two grants from the National Natural Science Foundation of China,No.30870686 and 81371530
文摘A reduction in gray matter volume is common in patients with chronic back pain, and different types of pain are associated with gray matter abnormalities in distinct brain regions. To examine differ- ences in brain morphology in patients with low back pain or neck and upper back pain, we investi- gated changes in gray matter volume in chronic back pain patients having different sites of pain using voxel-based morphometry. A reduction in cortical gray matter volume was found primarily in the left postcentral gyrus and in the left precuneus and bilateral cuneal cortex of patients with low back pain. In these patients, there was an increase in subcortical gray matter volume in the bilateral putamen and accumbens, right pallidum, right caudate nucleus, and left amygdala. In upper back pain patients, reduced cortical gray matter volume was found in the left precentral and left postcen- tral cortices. Our findings suggest that regional gray matter volume abnormalities in low back pain patients are more extensive than in upper back pain patients. Subcortical gray matter volume in- creases are found only in patients with low back pain.
