中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
39期
3196-3200
,共5页
张茜%王志红%张阳%张璐%耿左军%任璐%程金明
張茜%王誌紅%張暘%張璐%耿左軍%任璐%程金明
장천%왕지홍%장양%장로%경좌군%임로%정금명
偏头痛,伴先兆%偏头痛,无先兆%磁共振成像%局部一致性
偏頭痛,伴先兆%偏頭痛,無先兆%磁共振成像%跼部一緻性
편두통,반선조%편두통,무선조%자공진성상%국부일치성
Migraine with aura%Migraine without aura%Magnetic resonance imaging%Regional homogeneity
目的 采用静息态功能磁共振(rfMRI)方法通过对比无先兆偏头痛(MwoA)患者、有先兆偏头痛(MA)患者及健康人的大脑自发脑活动的局部一致性(ReHo)差异从而进一步阐明偏头痛的脑功能机制.方法 收集2014年3至10月就诊于河北医科大学第二医院神经内科门诊的发作间期的23例MwoA(MwoA组)和12例MA患者(MA组)以及25名性别、年龄、受教育程度相匹配的健康被试对照组,对其进行临床资料的采集及rfMRI检查.应用ReHo方法分析每个被试大脑的相邻体素的血氧水平依赖(BOLD)信号在同一时间序列中波动的一致性,比较三组受试者大脑ReHo值的差异.结果 MwoA组右侧丘脑、右侧壳核、右侧前额叶皮质、右侧海马的ReHo值显著高于健康对照组(P＜0.05).MA组右侧丘脑、右侧壳核、右侧小脑、脑干的ReHo值显著低于健康对照组,而右侧枕叶的ReHo值显著高于健康对照组(P＜0.05).与MA组相比,MwoA组右侧小脑、脑干的ReHo值显著增高(P＜0.05).结论 静息态下这些功能异常的脑区可能与MA及MwoA患者的疼痛调节功能受损相关.MA与MwoA脑区结果的异同可能反映出两者病理机制的异同.
目的 採用靜息態功能磁共振(rfMRI)方法通過對比無先兆偏頭痛(MwoA)患者、有先兆偏頭痛(MA)患者及健康人的大腦自髮腦活動的跼部一緻性(ReHo)差異從而進一步闡明偏頭痛的腦功能機製.方法 收集2014年3至10月就診于河北醫科大學第二醫院神經內科門診的髮作間期的23例MwoA(MwoA組)和12例MA患者(MA組)以及25名性彆、年齡、受教育程度相匹配的健康被試對照組,對其進行臨床資料的採集及rfMRI檢查.應用ReHo方法分析每箇被試大腦的相鄰體素的血氧水平依賴(BOLD)信號在同一時間序列中波動的一緻性,比較三組受試者大腦ReHo值的差異.結果 MwoA組右側丘腦、右側殼覈、右側前額葉皮質、右側海馬的ReHo值顯著高于健康對照組(P＜0.05).MA組右側丘腦、右側殼覈、右側小腦、腦榦的ReHo值顯著低于健康對照組,而右側枕葉的ReHo值顯著高于健康對照組(P＜0.05).與MA組相比,MwoA組右側小腦、腦榦的ReHo值顯著增高(P＜0.05).結論 靜息態下這些功能異常的腦區可能與MA及MwoA患者的疼痛調節功能受損相關.MA與MwoA腦區結果的異同可能反映齣兩者病理機製的異同.
목적 채용정식태공능자공진(rfMRI)방법통과대비무선조편두통(MwoA)환자、유선조편두통(MA)환자급건강인적대뇌자발뇌활동적국부일치성(ReHo)차이종이진일보천명편두통적뇌공능궤제.방법 수집2014년3지10월취진우하북의과대학제이의원신경내과문진적발작간기적23례MwoA(MwoA조)화12례MA환자(MA조)이급25명성별、년령、수교육정도상필배적건강피시대조조,대기진행림상자료적채집급rfMRI검사.응용ReHo방법분석매개피시대뇌적상린체소적혈양수평의뢰(BOLD)신호재동일시간서렬중파동적일치성,비교삼조수시자대뇌ReHo치적차이.결과 MwoA조우측구뇌、우측각핵、우측전액협피질、우측해마적ReHo치현저고우건강대조조(P＜0.05).MA조우측구뇌、우측각핵、우측소뇌、뇌간적ReHo치현저저우건강대조조,이우측침협적ReHo치현저고우건강대조조(P＜0.05).여MA조상비,MwoA조우측소뇌、뇌간적ReHo치현저증고(P＜0.05).결론 정식태하저사공능이상적뇌구가능여MA급MwoA환자적동통조절공능수손상관.MA여MwoA뇌구결과적이동가능반영출량자병리궤제적이동.
Objective To compare the interictal spontaneous brain activity between migraine without aura(MwoA) patients, Migraine with visual aura(MA) patients and healthy control subjects in order to provide further insights into the complex migraine pathophysiology.Methods Twenty-three eligible MwoA patients, twelve MA patients who were treated in the neurology clinics in the Second Hospital of Hebei Medical University from March to October 2014 and twenty-five gender-, age-and education-matched healthy volunteers participated in this study.After demographic and clinical characteristics were acquired, a 3.0-T MRI system was used to obtain rfMRI.ReHo method was applied to analyze the synchronization of the BOLD signal in the same time series among neighboring voxels of the brain.Results Compared with healthy controls, MwoA patients showed significant decreases in ReHo values in the right thalamus, right putamen, right prefrontal lobe and right hippocampus (P ＜ 0.05);while MA patients showed significant decreases in ReHo values in the right thalamus, right putamen, right cerebellum and brainstem, whereas a significant increase in ReHo values in the right occipital lobe (P＜0.05).Furthermore, compared with MA patients, increased ReHo values in the right cerebellum and brainstem were shown in the MwoA group (P ＜ 0.05).Conclusions The results suggest that the resting-state abnormalities of these regions may be associated with functional impairments in pain processing in migraine.Specifically, the results of brain regions may reflect both the similarities and differences of pathophysiological mechanisms relative to the major subtypes of migraine.
