带状疱疹后神经痛病人静息态镜像同伦功能连接研究
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摘要
目的:应用静息态功能磁共振成像(resting-state functional MRI, rs-fMRI)基于体素-镜像同伦连接(voxel-mirrored homotopic connectivity, VMHC)方法,探讨带状疱疹后神经痛(postherpetic neuralgia, PHN)病人两大脑半球之间的同伦功能连接改变。方法:利用3.0T MR采集18例右利手PHN病人(男性11例,女性7例;平均年龄,59.67±8.41岁)和18例相匹配的健康志愿者(男性11例,女性7例;平均年龄,38.50±7.51)的rs-f MRI数据。然后采用VMHC方法分析数据。结果:与健康对照组(healthy controls, HCs组)比较,PHN组背外侧前额叶、楔前叶和后扣带回(prefrontal cortex and the precuneus and posterior cingulate cortex, PCUN/PCC)存在VMHC显著下降。楔前叶和后扣带回(PCUN/PCC) VMHC下降与视觉模拟评分法(visual analog scale, VAS)疼痛评分呈正相关(ρ=0.651;P=0.006)。受试者工作特征(receiver operating characteristic, ROC)曲线分析显示前额叶和PCUN/PCC两个脑区ROC曲线下面积分别是0.898和0.923,表明VMHC可以用来区别PHN和HCs组。结论:PHN病人两大脑半球间功能连接下降,而且这也是一个重要的新的途径去探究和更好的理解PHN病人脑内源性功能构架断裂的本质。
Objective: To investigate the difference of cerebral inter-hemispheric functional connecticity between the patients with postherpetic neuralgia(PHN) and healthy controls(HC) by voxel-mirrored homotopic connectivity(VMHC) method based on resting-state functional MRI(rs-fMRI). Methods: Eighteen right-handed PHN patients(11 males, 7 females; mean age, 59.67±8.41 years) and 18 well-matched healthy controls(11 males, 7 females; mean age, 38.50±7.51 years) were examined by rs-fMRI on 3.0T MR imaging system(Siemens Trio Tim). Interhemispheric connectivity was examined using voxel-mirrored homotopic connectivity(VMHC). Results: Compared with the healthy controls, the patients with PHN showed significantly decreased homotopic connectivity in the dorsolateral prefrontal cortex and the precuneus and posterior cingulate cortex(PCUN/PCC). The decreased VMHC in the PCUN/PCC was positively correlated with the visual analog scale(VAS) of patients with PHN(r = 0.651; P = 0.006). Receiver operating characteristic(ROC) analysis revealed that the areas under the curves for the two brain regions were 0.898 for the prefrontal cortex and 0.923 for the PCUN/PCC, indicating that the VMHC could be used to discriminate PHN patients from healthy controls. Conclusion: Our results indicated that patients with PHN have reduced interhemispheric functional connectivity, which seems to be an important new avenue to better investigate and understand the nature of disconnection of the functional architecture in patients with PHN.
Objective: To investigate the difference of cerebral inter-hemispheric functional connecticity between the patients with postherpetic neuralgia(PHN) and healthy controls(HC) by voxel-mirrored homotopic connectivity(VMHC) method based on resting-state functional MRI(rs-fMRI). Methods: Eighteen right-handed PHN patients(11 males, 7 females; mean age, 59.67±8.41 years) and 18 well-matched healthy controls(11 males, 7 females; mean age, 38.50±7.51 years) were examined by rs-fMRI on 3.0T MR imaging system(Siemens Trio Tim). Interhemispheric connectivity was examined using voxel-mirrored homotopic connectivity(VMHC). Results: Compared with the healthy controls, the patients with PHN showed significantly decreased homotopic connectivity in the dorsolateral prefrontal cortex and the precuneus and posterior cingulate cortex(PCUN/PCC). The decreased VMHC in the PCUN/PCC was positively correlated with the visual analog scale(VAS) of patients with PHN(r = 0.651; P = 0.006). Receiver operating characteristic(ROC) analysis revealed that the areas under the curves for the two brain regions were 0.898 for the prefrontal cortex and 0.923 for the PCUN/PCC, indicating that the VMHC could be used to discriminate PHN patients from healthy controls. Conclusion: Our results indicated that patients with PHN have reduced interhemispheric functional connectivity, which seems to be an important new avenue to better investigate and understand the nature of disconnection of the functional architecture in patients with PHN.
引文
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[3]金文哲,任婷婷,李仁淑,等.背根神经节射频热凝对老年带状疱疹后神经痛疗效的影响[J].中国疼痛医学杂志, 2015, 21(1):69-71.
[4]YuB.Microstructuralabnormalitiesingraymatter ofpatientswithpostherpeticneuralgia:adiffusional kurtosis imaging study[J]. Pain Physician, 2016, 19(4):E601-E611.
[5]Geha PY, Baliki MN, Chialvo DR, et al. Brain activity for spontaneous pain of postherpetic neuralgia and its modulation by lidocaine patch therapy[J]. Pain, 2007,128(1):88-100.
[6]GehaPY,BalikiMN, WangX, et al.Braindynamics for perception of tactile allodynia(touch-induced pain)inpostherpeticneuralgia[J].Pain,2008,138(3):641-656.
[7]ZuoXN,KellyC,DiMartino A, etal.Growing together and growing apart:regional and sex differences in the lifespan developmental trajectories of functional homotopy[J]. J Neurosci, 2010, 30(45):15034-15043.
[8]LiJ,GaoL,XieK, etal.Detectionoffunctional homotopyintraumaticaxonalinjury[J].EurRadiol,Epub 2016 Apr 5.
[9]BiY,YuanK,FengD, etal.Disruptedinterhemisphericfunctionalandstructuralcouplingin Internet addiction adolescents[J]. Psychiatry Res, 2015,234(2):157-163.
[10]YanCG,WangXD,ZuoXN, etal.DPABI:data processing&analysis for(resting-state)brain imaging[J].Neuroinformatics, 2016, 14(3):339-351.
[11]YanCG,CheungB,KellyC, etal. Acomprehensive assessment of regional variation in the impact of head micromovementsonfunctionalconnectomics[J].Neuroimage, 2013, 76:183-201.
[12]Andrews-HannaJR,ReidlerJS,SepulcreJ, etal.Functional-anatomic fractionation of the brain's default network[J]. Neuron, 2010, 65(4):550-562.
[13]Shackman AJ,Salomons TV,SlagterHA, etal. The integrationofnegativeaffect,painandcognitive controlinthecingulatecortex[J].NatRevNeurosci,2011, 12(3):154-167.
[14]NielsenFA,BalslevD,HansenLK.Miningthe posterior cingulate:segregation between memory and pain components[J]. Neuroimage, 2005, 27(3):520-532.
[15]BalikiMN,GehaPY, Apkarian AV, etal.Beyond feeling:chronicpainhurtsthebrain,disruptingthe default-mode network dynamics[J]. J Neurosci, 2008,28(6):1398-1403.
[16]Lorenz J, Minoshima S, Casey K. Keeping pain out of mind:theroleofthedorsolateralprefrontalcortexin pain modulation[J]. Brain, 2003, 126(5):1079-1091.
[17]Rêgo G G,Lapenta O M,Marques L M, e ta l.Hemispheric dorsolateral prefrontal cortex lateralization in the regulation of empathy for pain[J]. Neurosci Lett,2015, 594:12-16.
[18]Sevel LS, Letzen JE, Staud R, et al. Interhemispheric dorsolateral prefrontal cortex connectivity is associated with individual differences in pain sensitivity in healthy controls[J]. Brain Connect, 2016, 6(5):357-364.
[19]?ekoM,Shir Y,OuelletJA, etal,SeminowiczDA.Partialrecoveryofabnormalinsulaanddorsolateral prefrontal connectivity to cognitive networks in chronic lowbackpainaftertreatment[J].HumBrainMapp,2015, 36(6):2075-2092.
[20]GuedonJM,YeeMB,ZhangM, etal.Neuronal changesinducedbyVaricellaZosterVirusinarat modelofpostherpeticneuralgia[J].Virology,2015,482:167-180.
[21]Cao S, Song G, Zhang Y, et al. Abnormal Local Brain ActivityBeyondthePainMatrixinPostherpetic NeuralgiaPatients:AResting-StateFunctionalMRI Study[J]. Pain Physician, 2017, 20(2):E303.