摘要
目的探讨基于磁共振脑功能成像与冻结肩患者慢性疼痛的相关性研究。方法使用rs-fMRI技术对64例原发性冻结肩慢性疼痛患者及64例健康志愿者进行低频振幅(amplitude of low-frequency fluctuation,ALFF)和格兰杰因果关系分析(granger causality analysis,GCA),血氧水平依赖(blood oxygen level dependent,BOLD)信号变化强度以zALFF值表示,感兴趣区(region of interest,ROI)与全脑之间的有效连接用格兰杰因果关系值(Z-transformed Granger causality,zGC)表示。使用Pearson相关评估zALFF值、zGC值与疼痛视觉模拟评分(visual analogue scale,VAS)的相关性。结果冻结肩组左侧岛叶、左侧背侧前扣带回、右侧背外侧前额叶zALFF值明显增高,双侧丘脑zALFF值明显降低(P<0.05,GRF校正);冻结肩组右侧丘脑的zALFF值与术前VAS评分呈显著负相关(r=-0.629,P=0.001);以右侧丘脑为ROI,冻结肩组从右侧丘脑到双侧额上回、右侧小脑的有效连接增强,从左侧岛叶、右侧楔前叶到右侧丘脑的有效连接减低,(体素水平P<0.001,GRF校正);冻结肩组患者左侧额上回和右侧丘脑的zGC值(1.03±1.06)与术后VAS评分呈正相关(r=0.558,P=0.005);右侧丘脑和右侧楔前叶间的zGC值(-0.89±0.47)与术前VAS评分呈负相关(r=-0.483,P=0.006)。结论冻结肩慢性疼痛患者静息态脑功能发生改变,且与治疗前后疼痛感知相关。
Objective To explore the relationship between the changes of resting-state brain function and pain before and after treatment in patients of frozen shoulder with chronic pain.Methods 64 patients with primary frozen shoulder chronic pain treated in our hospital from November 2016 to October 2019 were selected as FS group,and 64 healthy volunteers matched with sex,education level and age were recruited in the same period.Using Amplitude of low-frequency fluctuation(ALFF)and Granger causality analysis(GCA),the intensity of blood oxygen level-dependent(BOLD)signal change was represented by Z-converted zALFF value,and the effective connection between Region of interest(ROI)and the whole brain was represented by Z-converted Granger causality(zGC)value.Pearson was used to analyze the correlation between zALFF value,zGC value and VAS score before and after nerve block.Results In FS group,the zALFF values of left insula,left dorsal anterior cingulate gyrus and right dorsolateral prefrontal lobe were significantly increased,while the zALFF values of bilateral thalamus were significantly decreased(P<0.05,GRF correction).The zALFF value of the right thalamus in the FS group was negatively correlated with the preoperative VAS score.Using the right thalamus as ROI,the effective connections from the right thalamus to the right cerebellum and bilateral superior frontal gyrus were enhanced,and the effective connections from the left insula and right precuneus to the right thalamus were decreased in the FS group(voxel level P<0.001,GRF corrected).The preoperative VAS score of FS group was negatively correlated with zGC values(-0.89±0.47)of effective connection between right precuneus and right thalamus(r=-0.483,P=0.006).Postoperative VAS score was positively correlated with zGC values(1.03±1.06)of right thalamus and left superior frontal gyrus(r=0.558,P=0.005).Conclusion There are changes in resting-state brain function in patients of FS with chronic pain,which is related to pain perception before and after treatment.
作者
宋凌恒
兰晓川
姚阔
陆娟
朱春霞
李福锁
李锦青
禹智波
SONG Ling-heng;LAN Xiao-chuan;YAO Kuo;LU Juan;ZHU Chun-xia;LI Fu-suo;LI Jin-qing;YU Zhi-bo(Department of Radiology,958th Army Hospital of the People's Liberation Army,Chongqin 400020,China)
出处
《中国CT和MRI杂志》
2023年第7期163-165,共3页
Chinese Journal of CT and MRI
基金
重庆市自然科学基金(cstc2016jcyjA0188)。
关键词
冻结肩
慢性疼痛
静息态脑功能
相关性
Frozen Shoulder
Chronic Pain
Resting Brain Function
Correlation
