摘要
目的:观察帕金森病伴疼痛患者(PDP)与帕金森病不伴疼痛患者(nPDP)在接触性热痛刺激(CHS)下的脑功能磁共振成像(fMRI)特点,探索PDP痛觉相关脑网络,为PD疼痛的病理生理机制、临床分型及治疗等提供参考。方法:收集11例PDP(PDP组)与15例nPDP(nPDP组),同期招募17名性别、年龄匹配的健康成年人为对照组(NC组)。所有受试者均接受临床量表评估,右侧前臂背侧行51℃CHS同步fMRI扫描,观察三组间脑区激活差异。结果:与nPDP组相比,PDP组右小脑、右海马旁回、右舌回、右背外侧额上回、右眶部额上回脑区激活程度增强,双侧颞下回、双侧脑岛、左中央沟盖、左顶上回、左顶下缘角回脑区激活程度减弱(P<0.05)。与NC组相比,PDP组双侧小脑、双侧中央前回、左颞下回、左中央后回、右海马旁回、右海马、右舌回、左丘脑、左颞上回、右脑岛、右中央沟盖、左颞上回、左补充运动区、右梭状回脑区激活程度增强(P<0.05),未见激活降低的脑区。与NC组相比,nPDP组双侧小脑、双侧中央沟盖、双侧梭状回、双侧脑岛、左顶下缘角回、右颞下回、右海马旁回、左丘脑、左颞上回、左中央前回、左中央后回、右海马、左补充运动区、左颞横回、左顶上回脑区激活程度增强(P<0.05),未见激活降低的脑区。结论:多个脑区共同参与痛觉形成及处理,存在复杂的痛觉相关脑网络。CHS-fMRI可为PD患者痛觉相关脑功能研究提供客观手段,PDP痛觉相关脑网络发生改变,对PDP疼痛的病理生理机制研究有一定价值,可能有助于为PD患者临床分型、疗效评定提供参考信息。
Objective:To observe the features of functional magnetic resonance imaging(fMRI)of Parkinson’s disease with pain(PDP)and Parkinson’s disease without pain(nPDP)under contact hot pain stimulation(CHS),and explore the brain network related to pain in PDP,so as to provide valuable information for pathophysiological mechanism,clinical classification and treatment of pain in Parkinson’s disease(PD).Methods:11 PDP patients(PDP group)and 15 nPDP patients(nPDP group)were collected,and 17 healthy adults matched in sex and age were recruited as control group(NC group)at the same time.All subjects were evaluated by clinical scale,and then 51℃CHS synchronous fMRI scan was performed on the back of right forearm.The activation differences of brain regions among the three groups were observed.Results:Compared with nPDP group,the brain areas with enhanced activation degree in PDP group include right cerebellum,right parahippocampal gyrus,right lingual gyrus,right dorsolateral superior frontal gyrus and right orbital superior frontal gyrus,while the brain areas with weakened activation degree include bilateral inferior temporal gyrus,bilateral insula,lid of left central sulcus,left superior parietal gyrus and left inferior parietal angular gyrus(P<0.05).Compared with NC group,the brain regions with enhanced activation degree in PDP group include bilateral cerebellum,bilateral anterior central gyrus,left inferior temporal gyrus,left posterior central gyrus,right parahippocampal gyrus,right hippocampus,right lingual gyrus,left thalamus,left superior temporal gyrus,right insula,lid of right central sulcus,left superior temporal gyrus,left supplementary motor area and right fusiform gyrus.No brain area with decreased activation was found(P<0.05).Compared with NC group,the brain regions with enhanced activation degree in nPDP group include bilateral cerebellum,bilateral central sulcus,bilateral fusiform gyrus,bilateral insula,left inferior parietal gyrus,right inferior temporal gyrus,right parahippocampal gyrus,left thalamus,left superior temporal gyrus,left anterior central gyrus,left posterior central gyrus,right hippocampus,left supplementary motor area,left transverse temporal gyrus and left superior apical gyrus.No brain area with decreased activation was found(P<0.05).Conclusion:It is verified that multiple brain regions participate in pain formation and treatment,and there is a complex pain-related brain network.CHS-fMRI can provide an objective means for the study of pain-related brain function in PD patients.PDP pain-related brain network changes,which has a certain value for the study of the pathophysiological mechanism of PDP pain,and may help provide reference information for clinical classification and curative effect evaluation of PD patients.
作者
彭乔君
涂敏
王晓明
杨双凤
侯昌月
包娜娜
PENG Qiao-jun;TU Min;WANG Xiao-ming;YANG Shuang-feng;HOU Chang-yue;BAO Na-na(Department of Neurology,Affiliated Hospital of North Sichuan Medical College;Institute of Neurological Disease,North Sichuan Medical College,Nanchong 637000,Sichuan,China)
出处
《川北医学院学报》
CAS
2021年第9期1201-1206,共6页
Journal of North Sichuan Medical College
基金
国家发改委疑难病症诊治能力提升工程项目
四川省科技计划项目(2017JY0179)
南充市重点实验室项目(NCKL201906)。
关键词
帕金森病
疼痛
功能磁共振成像
接触性热痛刺激
脑功能网络
Parkinson’s disease
Pain
Functional magnetic resonance imaging
Contact thermal pain stimulation
Brain function network
