原发性月经痛患者大脑灰质结构异常研究

发布时间：2018-01-21 04:58

本文关键词： 原发性月经痛磁共振成像大脑皮层厚度分析基于体素的形态学分析慢性痛　出处：《西安电子科技大学》2014年硕士论文　论文类型：学位论文

【摘要】：原发性月经痛作为一种在月经周期中常常引起痉挛痛,同时增加疼痛的敏感性的妇科障碍性疾病。原发性月经痛的特点是月经持续一到三天。普遍的原发性月经痛患者在青少年女性患病人群中占有较大的比例。2005年报道称15%的青少年女性经历严重的月经痛,同时导致短期的缺勤。原发性月经痛作为一种妇科的障碍性疾病,严重的影响到女性的生活质量并带来巨大的医疗负担。近些年来,由于医学成像技术的蓬勃发展,特别是核磁共振成像技术和正电子发射计算机断层显像技术的广泛应用,已有许多关于原发性月经痛的研究。研究表明,原发性月经痛患者是由于大脑中涉及疼痛信息传递,更高层次的感觉处理,情感调节的区域灰质降低;涉及疼痛调制和内分泌的调控的区域灰质增加;同时在涉及疼痛处理区域代谢增加;涉及感觉运动区域的代谢减小。然而,这些研究大部分是基于PET和VBM的研究,很少有针对患者大脑皮层厚度异常变化的研究。因此,本论文利用核磁共振成像技术,研究原发性月经痛患者灰质解剖结构,包括大脑皮层厚度,灰质密度,皮下体积的异常变化。首先,采用CTA和VBM这些常用的分析模式来分析原发性月经痛患者与正常对照组,在月经期大脑区域灰质的异常变化。利用相关性分析和回归分析的方法,得到具有显著性相关的大脑异常变化区域,包括:顶叶皮质,楔前叶,上额叶皮质,后中央回,脑岛皮质,楔叶,后扣带,中额眶回,右后扣带,旁海马皮质,上颞叶皮质,前中央回,中颞叶皮质。此外,皮下体积分析发现显著性的差异,包括:左侧尾状核,左侧丘脑,左侧杏仁核,及其间脑。这些结构构成的脑网络有助于进一步了解原发性月经痛的在神经方面的发病机制,并且表明在大脑的不同模态下分析原发性月经痛的病理机制更深层次的研究具有可行性。其次,基于体素的形态测量学分析探究原发性月经痛患者灰质变化。结果发现:躯体感觉运动区,左侧脑岛区域,左侧额眶区域,中扣带区域和小脑区域。此外,这些区域与先前的相关研究的区域部分重叠。因此,这些研究结果表明原发性痛经患者灰质的异常变化,并且为揭示原发性月经痛在大脑区域灰质异常变化下发病机制提供了进一步的验证。
[Abstract]:Primary menstrual pain as a kind of menstrual cycle often causes spasmodic pain. A gynecological disorder that increases the sensitivity of pain at the same time. Primary menstrual pain is characterized by one to three days of menstruation. In 2005, it was reported that 15% of teenage women experienced severe menstrual pain. At the same time lead to short-term absence. Primary menstrual pain as a gynaecological disorder, seriously affect the quality of life of women and bring a huge medical burden in recent years. Due to the rapid development of medical imaging technology, especially the wide application of magnetic resonance imaging and positron emission computed tomography, there have been many studies on primary menstrual pain. Primary menstrual pain patients are due to the brain involved in pain information transmission, a higher level of sensory processing, emotional regulation of the gray matter in the region; Increased gray matter in areas involved in pain modulation and endocrine regulation; At the same time, metabolism increased in the pain management area; However, most of these studies are based on PET and VBM studies, and there are few studies on abnormal changes in cortical thickness in patients. In this paper, MRI was used to study the anatomical structure of gray matter in patients with primary menstrual pain, including the abnormal changes of cerebral cortex thickness, gray matter density and subcutaneous volume. CTA and VBM were used to analyze the abnormal changes of gray matter in menstrual region of patients with primary menstrual pain and normal controls. Correlation analysis and regression analysis were used. The abnormal regions of brain were obtained, including parietal cortex, precuneiform cortex, upper frontal cortex, posterior central gyrus, insular cortex, cuneate lobe, posterior cingulate band, middle frontal orbital gyrus, right posterior cingulate zone, and para-hippocampal cortex. In addition, subcutaneous volume analysis showed significant differences, including: left caudate nucleus, left thalamus, left amygdala. These structures form a brain network that helps to further understand the neurogenesis of primary menstrual pain. It also shows that it is feasible to analyze the pathological mechanism of primary menstrual pain in different modes of brain. Secondly. To explore the changes of gray matter in patients with primary menstrual pain based on morphometric analysis of voxel. The results showed that somatosensory motor area, left cerebral islet region, left frontal orbital region, middle cingulate zone and cerebellar area. These areas overlap with those of previous studies. Therefore, these findings suggest abnormal changes in gray matter in patients with primary dysmenorrhea. It also provides further evidence to reveal the pathogenesis of primary menstrual pain under abnormal changes of gray matter in the brain region.
【学位授予单位】：西安电子科技大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R711.51

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