CAJ | 학술논문

目的利用功能磁共振成像(fMRI)技术探讨静息状态下腰背痛受试者岛叶功能活动及连接特点.方法采用飞利浦3.0T Achieva磁共振成像仪分别采集12例健康志愿者在正常状态及腰背部疼痛时(向腰背部肌肉注射3％高渗盐水)静息态fMRI数据.利用DPARSF软件计算受试者在不同状态下双侧前、后岛叶的功能连接情况,选用spm8软件对所得数据进行配对t检验,得到疼痛状态下静息态岛叶的功能连接数据,并比较前、后岛叶的功能连接差异.结果受试者在腰背痛状态下其疼痛视觉模拟评分(VAS)为(6.02±1.96)分.受试者在腰背痛状态下岛叶与额叶、丘脑、海马旁回的功能连接增强,与后扣带回、楔前叶、颞叶、中央旁小叶、小脑扁桃体的功能连接减低；此外顶下小叶与前岛叶功能连接增强,与后岛叶功能连接减低(P＜0.001,K≥10).结论静息态下腰背痛受试者的岛叶功能连接存在异常,这可能与疼痛刺激引起一系列认知及情绪功能改变有关.
목적 이용공능자공진성상(fMRI)기술탐토정식상태하요배통수시자도협공능활동급련접특점.방법 채용비리포3.0T Achieva자공진성상의분별채집12례건강지원자재정상상태급요배부동통시(향요배부기육주사3％고삼염수)정식태fMRI수거.이용DPARSF연건계산수시자재불동상태하쌍측전、후도협적공능련접정황,선용spm8연건대소득수거진행배대t검험,득도동통상태하정식태도협적공능련접수거,병비교전、후도협적공능련접차이.결과 수시자재요배통상태하기동통시각모의평분(VAS)위(6.02±1.96)분.수시자재요배통상태하도협여액협、구뇌、해마방회적공능련접증강,여후구대회、설전협、섭협、중앙방소협、소뇌편도체적공능련접감저；차외정하소협여전도협공능련접증강,여후도협공능련접감저(P＜0.001,K≥10).결론 정식태하요배통수시자적도협공능련접존재이상,저가능여동통자격인기일계렬인지급정서공능개변유관.
Objective To investigate the functional activity and connectivity of the insular cortex at rest in persons with low back pain (LBP).Methods Twelve healthy subjects (male 6,female 6 ; age 24.8 ± 3.3 years) were given fMRI 3.0T scans at rest.Back muscle pain was then induced with an intramuscular injection of 3％ hypertonic saline solution and a second scan was performed.The pain-free and in-pain fMRI data were compared using paired t-tests to highlight any changes in the functional connectivity of the anterior and posterior insular cortex on both sides.Pain severity was quantified using a visual analogue scale (VAS).Results Ratings of LBP severity peaked at 6.02 ± 1.96 on the VAS.The functional connectivity of the inferior insular cortex with the frontal cortex,the thalamus and the parahippocampal gyrus was enhanced when the subjects were in pain,but connectivity with the posterior cingulate cortex,the precuneus,the temporal cortex,the paracentral lobule and the cerebellar tonsil was reduced.The inferior parietal lobule exhibited significantly enhanced connectivity with the anterior insular cortex,but reduced connectivity with the posterior insular cortex.In addition,the medial cingulate cortex displayed decreased functional connectivity with the anterior insular cortex,but increased functional connectivity with the posterior insular cortex when the subjects were in pain.Conclusion This study has revealed impeded functional connectivity of the insular cortex when experiencing LBP at rest.This may possibly be related to pain's disruption of cognition and emotion.