CAJ | 학술논문

目的：研究耳鸣患者静息态fMRI的区域一致性(regional homogeneity，Reho)值脑区功能及中枢网络连接特点，从神经影像学及功能连接方面进一步阐明耳鸣的中枢发病机制。方法对18例耳鸣患者与20例年龄、性别相匹配的健康人群的分别行静息态功能性核磁共振（fMRI）检查，分析比较其Reho值变化，再将异常脑区或听觉中枢做为种子点行功能网络连接，研究耳鸣患者的脑区及功能网络连接变化。结果ReHo表现为耳鸣组>正常组的脑区有双侧额下回、右侧颞中回、双侧中央后回；耳鸣组<正常组的脑区有小脑半球。经FWE严格校正后耳鸣组比对照组增强的区域为额下回（FWE P<0.05）减弱的区域为小脑前叶（FWE P<0.05, cluster level）。以额下回IFG作为种子点行功能连接，发现对照组>耳鸣组的区域为中脑（FWE，P<0.001）及右腹侧纹状体（FWE P<0.05，Small volume correction）。结论耳鸣的fMRI结果显示耳鸣患者的听觉中枢及非听觉中枢均在耳鸣中起重要作用，中枢功能连接提示耳鸣患者听觉脑区丘脑、颞中回与边缘系统海马旁回、岛叶等存在功能连接是导致耳鸣发生发展的原因之一。
목적：연구이명환자정식태fMRI적구역일치성(regional homogeneity，Reho)치뇌구공능급중추망락련접특점，종신경영상학급공능련접방면진일보천명이명적중추발병궤제。방법대18례이명환자여20례년령、성별상필배적건강인군적분별행정식태공능성핵자공진（fMRI）검사，분석비교기Reho치변화，재장이상뇌구혹은각중추주위충자점행공능망락련접，연구이명환자적뇌구급공능망락련접변화。결과ReHo표현위이명조>정상조적뇌구유쌍측액하회、우측섭중회、쌍측중앙후회；이명조<정상조적뇌구유소뇌반구。경FWE엄격교정후이명조비대조조증강적구역위액하회（FWE P<0.05）감약적구역위소뇌전협（FWE P<0.05, cluster level）。이액하회IFG작위충자점행공능련접，발현대조조>이명조적구역위중뇌（FWE，P<0.001）급우복측문상체（FWE P<0.05，Small volume correction）。결론이명적fMRI결과현시이명환자적은각중추급비은각중추균재이명중기중요작용，중추공능련접제시이명환자은각뇌구구뇌、섭중회여변연계통해마방회、도협등존재공능련접시도치이명발생발전적원인지일。
[Objective]To study central functional network connections and their alterations in tinnitus patients using fMRI. Meth-ods fMRI was performed in 18 tinnitus patients and 20 controls. Regional consistency (regional homogeneity or ReHo value) and functional network connection alterations were compared between the tinnitus patients and controls. Results Tinnitus pa-tients showed increased ReHo values in gyrus frontalis inferior and decreased ReHo values in anterior lobe of cerebellum in comparison with the controls. The regions with decreased ReHo values were bilateral inferior frontal gyrus, middle frontal gy-rus and anterior cingulate. Conclusions Abnormal fMRI changes in auditory cortex and non-auditory cortex are present in tin-nitus patients. The severity of tinnitus is linearly correlated to the changes in some brain regions. fMRI may be useful in evalu-ating tinnitus.