摘要
目的:带状疱疹后神经痛(postherpetic neuralgia,PHN)是一种顽固性神经病理性疼痛,然而对于其产生的病理机制还知之甚少。本研究将探讨PHN病人脑默认网络(default mode network,DMN)静息态功能连接(resting state functional connectivity,RSFC)模式的改变,及其与PHN的相关性。方法:收集26例带状疱疹后神经痛病人(PHN组)及与其性别、年龄、受教育程度相匹配的33名健康对照者(HC组)的一般人口学资料,进行相关临床量表评估;同时采集两组被试的大脑静息态功能磁共振(rs-f MRI)数据。将脑默认网络的关键脑区后扣带回(posterior cingulate cortex,PCC)作为感兴趣区(region of interest,ROI),采用基于种子点的功能连接(seed-based FC)的分析方法探讨两组间脑默认网络内功能连接的改变情况,并将功能连接差异脑区与临床量表评分之间行Pearson相关分析。结果:PHN组的VAS评分显著高于HC组(t=1.131,P=0.036),基于PCC为种子点的功能连接分析发现,与HC组相比,PHN组PCC与左侧额上回内侧(left superior frontal gyrus,L-SFG-Med)、左侧额中回(left middle frontal gyrus,L-MFG)、左侧顶上回(left superior parietal gyrus,L-SPG)和右侧楔前叶(right precuneus,R-PCUN)的功能连接增强;此外,PHN组PCC与左侧额上回(PCC-SFG_L)的功能连接值与VAS评分之间呈正相关(r=0.31,P=0.024)。结论:脑DMN的功能连接增强介导了PHN慢性持续疼痛的神经病理过程,是其产生的神经生物学基础和潜在的脑影像学标记。
Objective:Postherpetic neuralgia(PHN)is a kind of intractable neuropathic pain.However,the underlying mechanism is still poorly understood.We aimed to investigate the altered pattern of functional connectivity within default mode network in postherpetic neuralgia patients,and try to find the connection between the altered functional connectivity abnormality and PHN.Methods:26 PHN patients and 33 age,sex and educational level matched healthy controls(HCs)were enrolled.The resting state functional magnetic resonance imaging(RS-fMRI)was examined,and clinical behavioral and neuropsychological scale were assessed.We selected left posterior cingulate cortex(PCC)as the region of interest(ROI)and used seed-based temporal correlation analysis to assess the differences of resting state functional connectivity(RSFC)within default mode network between PHN and HC groups.Furthermore,we investigated the association of altered functional connectivity with clinical assessment scales in PHN patients using spearman correlation analysis.Results:PHN group had higher VAS scores than HC group.Functional connectivity analysis based on left PCC indicated that,compared with HC group,PHN patients showed increased RSFC of PCC with left superior frontal gyrus(L-SFG-Med),left middle frontal gyrus(L-MFG),left superior parietal gyrus(L-SPG),and right precuneus(R-PCUN).The correlation analysis indicated that significantly increased RSFC of PCC with L-SFG was positively correlated with VAS score(r=0.31,P=0.024).Conclusion:The increased default mode network connectivity mediated the process of neuropathogenesis in PHN.The increased default mode network connectivity is the neurobiological basis and maybe a potential neuroimaging biomarker for PHN.
作者
王进平
李光勤
吴士明
晏加林
李莉
贺曦
WANG Jin-Ping;LI Guang-Qin;WU Shi-Ming;YAN Jia-Lin;LI Li;HE Xi(Department of Neurology,the Emergency Medical Center of Chongqing,Chongqing 400014,China;Department of Neurology,the First Affiliated Hospital,Chongqing Medical University,Chongqing 400016,China;Department of Pain Medicine,the Xinqiao hospital,The Third Military Medical University,Chongqing 400037,China)
出处
《中国疼痛医学杂志》
CAS
CSCD
北大核心
2018年第8期603-609,614,共8页
Chinese Journal of Pain Medicine
基金
重庆市卫计委医学科研项目(2015ZBXM087)
关键词
带状疱疹后神经痛
功能磁共振成像
静息态功能连接
默认网络
Postherpetic neuralgia(PHN)
Functional magnetic resonance imaging
Resting state functional connectivity
Default mode network
