特发性耳鸣严重程度与情绪中枢功能性磁共振成像的相关性研究

发布时间：2018-11-19 07:11

【摘要】：目的:探讨特发性耳鸣患者情绪中枢兴奋性特点,及与耳鸣严重程度的相关性。方法:特发性耳鸣患者24例和对照组22例进行对照研究,耳鸣患者均行耳鸣匹配频率检查,耳鸣残疾评估量表(THI)、焦虑自评量表(SAS)及抑郁自评量表(SDS)为耳鸣严重程度评分。两组被试均行声刺激下任务态功能性磁共振检查,刺激强度均为120d B,耳鸣组的刺激频率分别为耳鸣患者的匹配频率;对照组的的刺激频率为1KHz。分别制作眶额皮质、杏仁核、前扣带回的mask,数据用spm8软件进行后处理,获得激活体积。xjview8.0软件获取激活区图像。以P0.05为差异具有统计学意义。结果:1.耳鸣组眶额皮层的激活体积平均值:140.63±122.703,对照组眶额皮层的激活体积平均值:87.00±112.936,两组比较无差异(Z=-1.826,P㧐0.05);耳鸣组杏仁核的激活体积平均值:7.17±14.708,对照组杏仁核的激活体积平均值:9.27±15.797,两组比较无差异(Z=-0.688,P㧐0.05);耳鸣组前扣带回的激活体积平均值:57.87±85.864,对照组前扣带回的激活体积平均值:36.50±47.073,两组比较无差异(Z=-0.133,P㧐0.05)。2.耳鸣组眶额皮层的激活体积分别与THI、SAS、SDS的得分行相关性分析,均无相关性(rs=0.201,P=0.346;rs=-0.390,P=0.059;rs=-0.242,P=0.255);耳鸣组杏仁核的激活体积分别与THI、SAS、SDS的得分行相关性分析,均无相关性(rs=0.372,P=0.073;rs=0.267,P=0.207;rs=0.156,P=0.466);耳鸣组前扣带回的激活体积分别与THI、SAS、SDS的得分行相关性分析,均无相关性(rs=-0.001,P=0.998;rs=-0.345,P=0.099;rs=-0.230,P=0.279)。结论:1.FMRI可以作为评估耳鸣严重程度的客观检查方法。2.特发性耳鸣患者的眶额皮层、前扣带回的激活体积较正常人的眶额皮层、前扣带回激活体积大。特发性耳鸣患者的杏仁核激活体积较正常人激活体积小。3.特发性耳鸣患者的眶额皮层、前扣带回和杏仁核激活体积与耳鸣严重程度、焦虑及抑郁无关。
[Abstract]:Objective: to investigate the characteristics of emotional central excitability in patients with idiopathic tinnitus and its correlation with the severity of tinnitus. Methods: 24 cases of idiopathic tinnitus and 22 cases of control group were studied. Tinnitus matching frequency examination and tinnitus disability assessment scale (THI),) were performed in all patients with tinnitus. Self-rating anxiety scale (SAS) and self-rating Depression scale (SDS) were the scores of tinnitus severity. The stimulation intensity was 120 dB, the stimulation frequency of tinnitus group was the matching frequency of tinnitus patients, and the stimulation frequency of control group was 1kHz. The mask, data of orbitofrontal cortex, amygdala and anterior cingulate gyrus were processed with spm8 software to obtain the activation volume. Xjview8.0 software was used to obtain the activation region images. P0.05 as the difference was statistically significant. The result is 1: 1. The average activation volume of orbital frontal cortex was 140.63 卤122.703 in tinnitus group and 87.00 卤112.936 in control group. There was no difference between the two groups. The average activation volume of amygdala was 7.17 卤14.708 in tinnitus group and 9.27 卤15.797 in control group. The average activated volume of anterior cingulate gyrus was 57.87 卤85.864 in tinnitus group and 36.50 卤47.073 in control group. There was no correlation (rs=0.201,P=0.346;rs=-0.390,P=0.059;rs=-0.242,P=0.255) between the activation volume of orbital frontal cortex and the score of THI,SAS,SDS in tinnitus group. There was no correlation (rs=0.372,P=0.073;rs=0.267,P=0.207;rs=0.156,P=0.466) between the activation volume of amygdala and the score of THI,SAS,SDS in tinnitus group. There was no correlation (rs=-0.001,P=0.998;rs=-0.345,P=0.099;rs=-0.230,P=0.279) between the activation volume of anterior cingulate gyrus and the score of THI,SAS,SDS in tinnitus group. Conclusion: 1.FMRI can be used as an objective method to evaluate the severity of tinnitus. 2. The activation volume of orbital frontal cortex and anterior cingulate gyrus in idiopathic tinnitus patients was larger than that in normal subjects. The activation volume of amygdala in patients with idiopathic tinnitus was smaller than that in normal subjects. The activation volume of orbital frontal cortex, anterior cingulate gyrus and amygdala in idiopathic tinnitus patients was not related to the severity of tinnitus, anxiety and depression.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R764.45

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