基于体素形态学测量慢性椎间盘源性下腰痛患者脑灰质体积的研究

发布时间：2018-02-26 15:11

本文关键词： 腰椎间盘突出症下腰痛基于体素形态学灰质　出处：《川北医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨椎间盘源性下腰痛患者脑灰质体积的变化,以及与疼痛程度、病程的关系,进而了解椎间盘源性下腰痛的脑神经机制。方法:根据纳入和排除标准选取出22例椎间盘源性下腰痛(Low back pain,LBP)患者(LBP组)和22名健康对照组(Health control,HC组)志愿者(HC组),对所有受试者进行疼痛程度视觉模拟评分(Visual analog scale,VAS)以及三维T1加权快速扰相梯度回波(Fast spoiled gradient recall,FSPGR)序列结构像数据采集。然后采用基于MATLAB 2010平台的SPM8及REST 1.8软件包对数据进行如下处理:(1)对所有受试者的图像进行预处理后,采用两独立样本t检验比较LBP组和HC组大脑灰质体积(Gray matter volume,GMV)的差异,单体素阈值取P0.001,多重比较校正采用cluster水平FWE校正。(2)将灰质体积有差异的脑区作为感兴趣区,对感兴趣区灰质体积与LBP组患者视觉模拟评分(Visual analog scale,VAS)及病程进行偏相关分析,并控制年龄、性别的影响。结果:(1)与HC组相比,LBP组患者大脑皮层多个脑区灰质体积减小,包括右侧额上回、左侧额内侧回、左侧直回、右侧颞上回、右侧颞中回、右侧岛叶以及右侧额下回(P0.001,FWEc校正);无灰质体积增大的区域。(2)上述具有统计学差异脑区的灰质体积与VAS评分及病程均未见明显相关性(P0.05)。结论:慢性椎间盘源性LBP可引起广泛的脑功能区GMV的减低,这些脑区主要涉及感觉、认知及情绪,一定程度上揭示了慢性椎间盘源性LBP的脑神经机制。
[Abstract]:Objective: to investigate the changes of gray matter volume in patients with low back pain caused by intervertebral disc, and the relationship between the volume of gray matter and the degree of pain and the course of disease. Methods: according to the criteria of inclusion and exclusion, 22 patients with low back pain (LBP group) and 22 healthy controls (control group HC) were selected. Visual analog scale scale (VAS) and 3D T1 weighted Fast spoiled gradient echo (FSPGR) sequence were used to collect the structural image data of all subjects. Then the logarithm of SPM8 and REST 1.8 software package based on MATLAB 2010 was used. According to the following processing: 1) after preprocessing the images of all the subjects, Two independent t-test samples were used to compare the difference of gray matter volume between LBP group and HC group. The threshold value of monomeric substance was taken as P0.001, and the cluster level FWE correction was used for multiple comparison correction. The partial correlation analysis of gray matter volume in the area of interest with visual analog scalevolume and course of disease in LBP group was carried out, and the influence of age and sex was controlled. Results compared with HC group, the gray matter volume of multiple cerebral cortex regions in LBP group decreased. Including right superior frontal gyrus, left medial frontal gyrus, left straight gyrus, right superior temporal gyrus, right middle temporal gyrus, Right insular lobe and right inferior frontal gyrus P0.001FWEc correction; no increase of gray matter volume.) there is no significant correlation between gray matter volume and VAS score and course of disease. Conclusion: chronic discogenic LBP can be used. Causing a reduction in GMV in a wide range of brain functional areas, These brain regions are mainly involved in sensation, cognition and emotion, which to some extent reveal the brain neural mechanism of chronic discogenic LBP.
【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2;R681.5

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