基于偏头痛的大脑局部形态学损伤和全局功能网络异常研究

发布时间：2019-01-24 09:15

【摘要】：偏头痛是神经系统疾病中最常见的一种，发作时常伴有心率加快、面色苍白、恶心、呕吐等症状，同时对光和声音变得敏感。偏头痛对人体危害很大，长期的偏头痛困扰会导致患者学习和工作能力下降。随着病程以及发作频率的增加，偏头痛患者将会造成失能，甚至可能增加患精神疾病的风险。现代神经影像学技术的发展，有利于对偏头痛患者大脑结构和功能的改变进行研究。本文通过重复观察时隔一年的早期临床阶段无先兆偏头痛病人的大脑结构图像，利用基于体素的形态学测量方法以及基于纤维束的空间统计方法，分析无先兆早期临床阶段偏头疼病人一年前与一年后的灰质和白质的差异。另外，，我们采集108名无先兆偏头痛患者的大脑功能磁共振数据，根据病程将患者分为40组。分别构建患者与正常被试的大脑功能网络。将每组患者与正常被试组所构建的大脑功能连接进行统计分析，得到40组差异网络，分析40组差异网络的基本属性，探讨病程对患者大脑功能网络的影响。根据研究结果，无先兆偏头疼病人一年后的头痛频率明显比一年前提高。病人头痛持续时间和平均头痛强度没有显著差异。VBM的纵向研究发现，一年后无先兆偏头痛患者大脑中存在几个脑区的灰质密度显著降低，包括额上回的背外侧和内侧，眼窝前额皮层，海马体，楔前叶，顶下小叶，顶上小叶，中央后回，中央旁小叶和缘上回。分析临床变量与部分脑区灰质密度的相关性，发现这些脑区灰质密度与头痛参数呈负相关。无先兆偏头痛患者一年前与一年后的FA、MD、AD和RD分析在TFCE校正阈值范围内没有显著差异。对大脑功能网络的研究发现，随着病程的增加，无先兆偏头痛患者与正常被试组的差异连接越来越多，逐渐发展成一个差异网络。40组差异网络的节点度分布随着病程的增加逐渐符合幂律分布现象，另外，大脑功能网络的平均连接强度与病程呈正相关。针对病程最重一组的差异网络研究，我们发现该网络存在Rich Club现象，并且面对随机攻击和目标攻击，该差异网络都比随机网络表现出更强的鲁棒性。
[Abstract]:Migraine is one of the most common diseases of the nervous system, often accompanied by increased heart rate, pale face, nausea, vomiting, and become sensitive to light and sound. Migraine is very harmful to human body, long-term migraine will lead to the patient's learning and work ability decline. As the course and frequency of attack increase, migraine patients will cause disability, and may even increase the risk of mental illness. The development of modern neuroimaging technology is helpful to study the changes of brain structure and function in migraine patients. The brain structure images of patients with migraine without aura in the early clinical stage of one year were observed repeatedly, and the morphometric method based on voxel and the spatial statistical method based on fiber bundle were used. To analyze the difference of gray matter and white matter between one year ago and one year after migraine in early clinical stage without aura. In addition, 108 patients with migraine without aura were divided into 40 groups according to their course of disease. The brain function networks of patients and normal subjects were constructed. The functional connections between each group of patients and normal subjects were statistically analyzed and 40 groups of differential networks were obtained. The basic properties of 40 groups of differential networks were analyzed and the effects of course of disease on the brain functional networks of patients were discussed. According to the results, the frequency of headache in patients without aura was significantly higher after one year than a year ago. There was no significant difference in headache duration and mean headache intensity. A longitudinal VBM study found that a year later there were significant decreases in gray matter density in several areas of the brain in patients with no aura migraine, including dorsolateral and medial areas of the superior frontal gyrus. Frontal cortex, hippocampal body, anterior cuneate lobe, inferior parietal lobule, superior parietal lobule, posterior central gyrus, paracentral lobules and superior marginal gyrus. By analyzing the correlation between clinical variables and gray matter density in some brain regions, a negative correlation between gray matter density and headache parameters was found. There was no significant difference between FA,MD,AD and RD analysis in patients with migraine without aura one year before and after one year in the range of TFCE correction thresholds. As the course of disease increases, the difference between patients with migraine without aura and normal subjects is increasing, according to a study of brain functional networks. The node degree distribution of 40 groups of differential networks is in accordance with the power law distribution with the increase of the course of disease. In addition, the average connection strength of the brain functional network is positively correlated with the course of disease. In this paper, we find that the Rich Club phenomenon exists in this network, and it is more robust than the random network in the face of random attack and target attack.
【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】：R747.2

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