慢性偏头痛患者静息态功能磁共振研究

发布时间：2018-03-19 09:54

本文选题：慢性偏头痛　切入点：静息态功能磁共振　出处：《河北医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:慢性偏头痛(chronic migraine,CM)是一类发作频繁、每月超过15天且病程超过3月的偏头痛,发病时经常伴有颅神经、胃肠道及自主神经症状。以往诸多研究均证实偏头痛患者存在脑部结构、功能等异常,但只有少部分研究对慢性偏头痛进行了探讨。静息态功能磁共振(resting-state functional magnetic resonance imaging,rs-f MRI)反映的是静息状态下脑部的活动,这有助于理解慢性偏头痛的发病原理。本研究运用局部一致性(regional homogeneity,ReHo)方法对慢性偏头痛患者与健康受试者脑部自发活动的特征进行比较、分析。方法:本研究招募了性别、年龄、受教育程度均匹配的慢性偏头痛患者和健康对照者各20名,运用静息态功能磁共振局部一致性(regional homogeneity,ReHo)分析方法对两组的脑功能状况进行评价。在Matlab R2010a操作环境下,使用DPARSFA 2.2软件进行数据预处理和后处理,使用REST软件进行统计分析。首先对两组分别进行单样本t检验(P0.001,Alphasim corrected)以查看各组默认网络情况,再进行双样本t检验(P0.05,Alphasim corrected)以比较组间差异,最后对病例组差异脑区的ReHo均值与病程、发病频率、视觉模拟评分(visual analogue scale,VAS)等进行相关性分析。结果:病例组与健康对照组后扣带回(posterior cingulate cortex,PCC)、内侧前额叶皮质(medial prefrontal cortex,MPFC)、顶下小叶(inferior parietal lobe,IPL)、楔前叶的ReHo值与其它脑区相比显著升高(P0.001,Alphasim corrected),提示默认网络正常。与健康对照组相比,病例组前扣带回(anterior cingulate cortex,ACC)的ReHo值显著升高,左侧基底神经节(basal ganglia,BG)、右侧小脑的ReHo值显著降低(P0.05,Alphasim corrected),升高及降低的t值最高点分别位于ACC和左侧BG。且进一步研究尚未发现病例组差异脑区的ReHo均值与病程、发病频率、VAS评分等有显著相关性。结论:本研究运用ReHo方法分析慢性偏头痛患者局部脑功能,发现ReHo值异常脑区和慢性偏头痛患者静息态下脑功能存在异常。该发现可能与痛觉调节系统的结构和功能受损有关，也为今后慢性偏头疼的诊断和预防性治疗带来启发。
[Abstract]:Objective: chronic migraine headache (CMM) is a kind of migraine with frequent onset, more than 15 days per month and the course of disease exceeding March, which is often accompanied by cranial nerve. Symptoms of gastrointestinal tract and autonomic nervous system. Previous studies have confirmed that migraine patients have abnormal brain structure and function. But only a few studies have studied chronic migraine. Resting state functional magnetic resonance imagingrs-f MRIs reflect brain activity in resting states. This is helpful to understand the pathogenesis of chronic migraine. In this study, the characteristics of spontaneous brain activity in patients with chronic migraine were compared with those in healthy subjects by using the regional homogenicity (ReHoA) method. Twenty patients with chronic migraine and 20 healthy controls with matched educational level were evaluated by rest functional magnetic resonance (fMRI) regional homogeneity (ReHoA) analysis. The brain function of the two groups was evaluated under the Matlab R2010a operating environment. DPARSFA 2.2 software was used for data preprocessing and post processing, and REST software was used for statistical analysis. First, two groups were tested with single sample t test (P0.001 ~ Alphasim corrected) to see the default network situation in each group. In order to compare the difference between the two groups, the mean value of ReHo, the course of disease and the frequency of the disease were compared between the two groups by the double t-test (P0.05Alphasim corrected). Results: the posterior cingulate cingulate cortexus of the posterior cingulate gyrus of the case group and the healthy control group were analyzed. Results: the ReHo value of the anterior cuneate lobe was significantly higher than that of the other brain regions. The medial prefrontal cortex was medial prefrontal cortextate MPFCs, and the inferior parietal lobules were inferior parietal lobegos. The value of ReHo in the anterior cuneate lobe was significantly higher than that in the other brain regions. The default network is normal, indicating that the default network is normal, compared with the healthy control group. The ReHo value of anterior cingulate cortexa of anterior cingulate gyrus in the case group was significantly higher than that in the control group. The ReHo values of the right cerebellum decreased significantly in the left basal ganglia and the right cerebellum, and the highest t values of the increased and decreased t values were located in the ACC and the left BGs.Furthermore, the mean value of ReHo and the course of disease in the different brain regions of the patients were not found. Conclusion: the ReHo method is used to analyze the regional brain function of patients with chronic migraine. It was found that the abnormal brain function in the patients with abnormal ReHo value and in the resting state of patients with chronic migraine may be related to the damage of the structure and function of the pain regulating system, and also provide inspiration for the diagnosis and prophylactic treatment of chronic migraine in the future.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R747.2

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