功能性近红外光谱技术在慢性疼痛致前额叶变化中的应用进展

疼痛是人体的五大生命体征之一,其发生率较高。疼痛被国际疼痛协会(International Association for the Study of Pain,IASP)定义为实际或者潜在组织损伤所引起的一种不愉快的感觉或情感体验。长期疼痛导致病人睡眠紊乱、精神不振等后果,甚至严重影响病人的生命与生活质量。     

基于功能性近红外光谱的孤独症谱系障碍儿童可视音乐任务下大脑前额叶激活程度的研究

目的：基于功能性近红外光谱（functional near-infrared spectroscopy,fNIRS）探讨可视音乐任务对孤独症谱系障碍（autism spectrum disorder,ASD）儿童的大脑前额叶激活程度的影响。方法：本研究纳入18例孤独症谱系障碍儿童（ASD组）和18例正常儿童（TD组）,使用22通道fNIRS系统测量两组儿童大脑前额叶静息态和可视音乐任务中儿童大脑前额叶的HbO情况。数据处理和分析通过NIRS-KIT处理软件包和其他内部自定义的MatlabR2013b实现。结果：ASD儿童被激活的通道数比TD儿童少;TD儿童rDLPFC、rFPC、mFPC、lDLPFC、lFPC区域任务态HbO的β值的平均值大于静息态的（P<0.05）,而ASD儿童仅表现为lDLPFC区域任务态HbO的β值的平均值大于静息态的（P<0.05）;TD组儿童的rFPC、lDLPFC、lFPC区域的HbO改变量大于ASD组（P<0.05）。结论：ASD儿童大脑前额叶存在功能激活的弱化,可视音乐任务的即时效应可以使ASD儿童大脑前额叶lDLPFC区域HbO激活...     

基于功能性近红外光谱技术的不同吞咽任务态前额叶皮质功能研究

目的：采用功能性近红外光谱技术（functional near-infrared spectroscopy,fNIRS）研究不同吞咽任务态前额叶皮质激活情况。方法：纳入19例健康成人受试,在fNIRS采集过程中执行经注射器小口吞咽及经吸管连续吞咽任务,分析不同吞咽任务态前额叶皮质激活模式的差异。结果：在执行小口吞咽任务态,前额叶中显著激活的亚区为双侧的腹外侧前额叶皮层（ventrolateral prefrontal,VLPFC）;执行连续吞咽任务态,前额叶中显著激活的亚区为右侧腹外侧前额叶皮层、双侧的背外侧前额叶皮层（dorsolateral prefrontal cortex,DLPFC）及双侧的眶额皮层（orbitofrontal cortex,OFC）,其中右侧额极区（frontopolar prefrontal cortex,FPC）激活呈边缘化显著。经配对t检验发现,连续吞咽任务在右侧背外侧前额叶皮层（DLPFC）及右侧额极区（FPC）中的激活程度明显高于小口吞咽任务（P<0.05）。结论：fNIRS可应用于吞咽相关的脑功能研究。前额叶参与吞咽过程,并且以接近自然状态...     

静息态下孤独症谱系障碍儿童大脑前额叶的功能连接特征研究

目的：采用功能性近红外光谱技术(fNIRS)探究孤独症谱系障碍(ASD)、典型发育的正常儿童(TD)在静息状态下大脑前额叶功能连接的特征。方法：纳入3—7岁18例ASD儿童和18例TD儿童受试者,用fNIRS采集儿童大脑前额叶8min静息态数据。基于氧合血红蛋白(HbO₂)、脱氧血红蛋白(HbR)在时间序列上的浓度,采用相关系数分析,计算两组受试者静息态下的功能连接强度,并比较两组儿童功能连接强度之间的差异。结果：基于HbO₂、HbR的功能连接分析发现,与TD组相比,ASD组儿童大脑前额叶的功能连接强度显著降低(P<0.05),且HbO₂的数据结果比HbR的更加灵敏;两组儿童功能连接强度之间的差异主要体现在CH2和CH12的位置(P<0.05),相当于大脑皮层内侧前额叶皮层(m PFC)位置。结论：与TD儿童相比,ASD儿童的大脑前额叶的功能连接弱于TD儿童。内侧前额叶皮层(mPFC)的异常功能连接,可能是ASD儿童影响沟通交流障碍的神经机制之一。     

工作记忆中整合物体和位置信息时的前额叶激活

目的：利用功能磁共振成像（fMRI）技术研究了情节缓存中信息整合过程的脑机制。方法：8名正常被试在MR扫描中执行工作记忆任务，“组合”（bound）条件下物体出现在外周某个位置，“未组合”（unbound）条件下，同时呈现一个位于中心的物体和一个在外周某个位置的十字，让被试将物体想象到十字所在位置，要求被试判断再次出现的物体是否在曾经见过的位置（“组合”条件）或曾经想象过的位置（“未组合”条件）。结果：“未组合”条件相对于知觉“组合”条件，在双侧额中回／额下回、顶叶和小脑等区域出现了显著激活；“组合”条件相对于”未组合”条件没有任何激活。结论：本研究表明前额叶皮层在没有知觉表征情况下建立新的整合表征中具有重要作用。现有研究已证明前额叶皮层在建构和保持整合信息中的作用，本文进一步的研究提示它可能是情节缓存中信息整合的神经基础。     

抑郁症与双侧前额叶区能量代谢、脑缺血灶的关系研究

目的：利用头颅MRI和氢质子磁共振波谱(¹H-magnetic resonance spectroscopy,¹H-MRS)扫描未经治疗的首发抑郁症(major depressive disorder,MDD)患者,研究能量代谢产物与脑缺血灶之间的关系,探究MDD的发病机制及为诊断提供影像学依据。方法：选取2020年10月—2022年10月在石河子大学第一附属医院就诊的门诊及住院首次发病未经治疗的MDD患者79例,设为MDD组;另选取同期60名健康者为对照组。对两组纳入对象均进行头颅MRI和1H-MRS扫描,测量双侧前额叶肌酸(Cr)、N-乙酰天门冬氨酸(NAA)、胆碱(Cho)峰下面积,得出NAA/Cr、Cho/Cr值。开展MDD组与对照组显著性差异研究。结果：MDD组中,无脑缺血灶为20例,59例显示为不同部位的多发小缺血灶;对照组中,无脑缺血灶39例,21例表现不同部位的多发小缺血灶;其中对照组21例和MDD组59例均表现为不同部位慢性多发缺血灶。结论：抑郁症患者双侧前额叶的NAA/Cr、Cho/Cr能量代谢异常,且低于正常人;抑郁症患...     

抑郁症中医辩证与前额叶及海马^1H-MRS的相关性探讨

目的 探讨抑郁症中医辨证分型与前额叶及海马磁共振氢质子波谱(1H-MRS)变化的相关性.方法 随机选取60例抑郁症患者,辨证分型为A组(痰热型)、B组(瘀血型)、C组(虚热型)、D组(寒湿型)四型,应用三维磁共振氢质子波谱(3D1 H-MRS)检查,并分别与20例健康者对照,比较双侧前额叶背外侧白质和海马组织氮-乙酰天门冬氨酸(NAA)/胆碱(Cho)、NAA/肌酸(Cr)和Cho/Cr的比值.结果 A、C组双侧前额叶Cho/Cr与对照组的差异有显著性意义(P<0.05);B、C、D三组双侧海马NAA/Cr与对照组的差异有显著性意义(P<0.05).结论 抑郁症患者前额叶、海马部位的相关生化物质代谢改变与不同中医证型有一定相关性.     

伴和不伴焦虑症状的抑郁症患者脑功能性近红外光谱成像频谱特征

目的 探讨伴和不伴焦虑症状的抑郁症患者脑功能性近红外光谱成像频谱特征,以为其临床诊断和鉴别诊断提供帮助。方法 对30例伴有焦虑症状的抑郁症患者（A组）、28例不伴有焦虑症状的抑郁症患者（B组）分别进行功能性近红外光谱成像检测,分析功能性近红外光谱成像前额区和双侧颞区频谱S积分值、K斜率值、T重心值,并和正常对照组（C组30名）进行对比。结果 A组、B组前额区、双侧颞区S积分值较C组降低,差异有统计学意义（P<0.01）,但A组和B组之间差异无统计学意义（P>0.05）;A组较B组和C组前额区、双侧颞区K斜率值变小,前额区T重心值变大,差异有统计学意义（P<0.01）。Pearson相关分析显示,A组、B组前额区S积分值与其汉密顿抑郁量表中的阻滞因子分呈负相关（P<0.05）;A组、B组双侧颞区S积分值与其汉密顿抑郁量表中的认知障碍因子分呈负相关（P<0.05）;A组前额区T重心值与其汉密顿抑郁量表中的焦虑/躯体化因子及汉密顿焦虑量表评分呈正相关（P<0.05）。结论伴和不伴有焦虑症状的抑郁症患者具有相对特征性的功能性近红外光谱成像频谱,并与其临床症状...     

前额叶在老年人吞咽中作用的任务态功能磁共振研究

目的 通过任务态功能性磁共振（fMRI）技术观察老年人的吞咽活动和认知网络,分析两者关系。 方法 选取13名健康老年人,年龄61～82岁,蒙特利尔认知评估量表（MoCA）评分≥26分,吞咽造影检查（VFSS）显示吞咽时无渗漏、误吸,行吞咽和认知任务态fMRI,分析两任务的激活脑区。 结果 吞咽和认知任务存在共同的激活脑区,即双侧小脑、枕叶、中央前回、中央后回、额中回、下顶叶等。吞咽任务中右侧前额叶正激活,左侧前额叶大部分为负激活,而认知任务中双侧前额叶均为正激活,且吞咽任务感觉区的激活范围大于运动区。 结论 老年人吞咽活动中右侧前额叶更具优势,右侧前额叶为吞咽和认知活动共同的神经节点。     

大脑前额叶多通道近红外光谱信号数据的分类鉴别

背景：精神分裂症主要是通过症候学的方法进行诊断,近年来通过神经影像技术与模式识别的结合对精神分裂症患者与正常人进行鉴别的研究已经引起人们的兴趣。 目的：利用模式识别的方法对精神分裂症患者和正常人的大脑前额叶多通道近红外光谱信号数据进行分类鉴别,验证其可行性。 方法：使用言语流畅性测验作为激活任务,采集精神分裂症患者和正常人的大脑前额叶的近红外光谱信号数据。对采集数据进行预处理后计算各通道均值作为特征,计算接收者操作特征的曲线下方面积对通道特征进行分类性能排序,使用支持向量机按性能排序的特征组合做分类,然后用留一验证法计算分类性能指标,验证分类能力。 结果与结论：研究发现特征性能排序前8位的特征组合的准确度最高达到95.24%,并且这8个通道都位于右侧前额叶。推断右侧前额叶区域可能是影响精神分裂症患者的主要脑区,因此根据结果可以推断出近红外光谱数据通过与模式识别方法的结合可以成为辅助诊断精神分裂症病患者的一种手段。     

Hypofrontality and microvascular dysregulation in remitted late-onset depression assessed by functional near-infrared spectroscopy

Accumulated evidence suggests the involvement of vascular factors in late-onset depression. Late-onset depression has characteristics of poor outcome, cognitive decline, and high prevalence rather than early-onset depression. The aim of the present study was to determine whether or not the functional hypofrontality--that is, hypoperfusion and hypometabolism in the frontal lobes-seen in late-onset depression is a trait-dependent abnormality of microvascular regulation. This study was conducted on 10 patients with remitted late-onset major depressive disorder (MDD) and 10 healthy volunteers matched for vascular factors and subcortical, or white matter, hyperintensities (WMH). Using near-infrared spectroscopy combined with magnetic resonance imaging, we investigated the microvascular reactivity in the prefrontal cortex during a cognitive task and during carbon dioxide (CO(2)) inhalation. Activation of the prefrontal cortex during the cognitive task was significantly less in patients as compared with controls, although task performance was not significantly different between the two groups. In the patients, a tendency of negative correlation between the reduced prefrontal activation during a cognitive task and the severity of hyperintensity in periventricular region was observed. Vasomotor reactivity to CO(2) inhalation was significantly lower in the patients than in the controls. Although there was no significant association between the activation during the cognitive and that during the CO(2) inhalation task, the present results suggest that prefrontal microvascular dysregulation as shown by NIRS is involved in the pathophysiological basis of functional hypofrontality in late-onset depression. This finding will provide a new framework for the development of diagnostic methods, treatments, and preventive strategies against late-onset depression.     

Frontal lobe function in bipolar disorder: a multichannel near-infrared spectroscopy study

Frontal lobe dysfunction has been implicated as one of the pathophysiological bases of bipolar disorder. Detailed time courses of brain activation in the bipolar disorder group were investigated using multichannel near-infrared spectroscopy (NIRS), a recently developed functional neuroimaging technology with a high time resolution, and were compared with those in the major depression and healthy control groups. Seventeen patients with bipolar disorder, 11 equally depressed patients with major depression, and 17 healthy controls participated in the study. Changes in oxy hemoglobin concentration ([oxy-Hb]) during cognitive and motor tasks were monitored using frontal and temporal probes of two sets of 24-channel NIRS machines. [oxy-Hb] increases in the bipolar disorder group were smaller than those in the healthy control group during the early period of a verbal fluency task, larger than those in the major depression and healthy control groups during the late period of this task, and were smaller than those in the major depression group during a finger-tapping task. Depressive symptoms and antidepressant dosages did not correlate with [oxy-Hb] changes in the two patient groups. Bipolar disorder and major depression were characterized by preserved but delayed and reduced frontal lobe activations, respectively, in the present high-time-resolution study by multichannel NIRS.     

Prefrontal hemodynamic activity predicts false memory--a near-infrared spectroscopy study

Evidence from lesion studies suggests an important role of the prefrontal cortex (PFC) in the reconstructive processes of episodic memory or memory distortion. Results from functional imaging studies imply PFC involvement during the illusionary recollection of non-experienced events. Here, we used a two-channel near-infrared spectroscopy (NIRS) system and conducted real-time monitoring of PFC hemodynamics, while subjects studied word lists and subsequently recognized unstudied items (false recognition). Bilateral increases in the oxygenated hemoglobin concentration ([oxy-Hb]) were observed during false recognition compared to true recognition, and a left PFC dominant increase of [oxy-Hb] was observed during encoding phases where subjects later claimed that they recognized unstudied words. Traces of semantic processing, reflected primarily in the left PFC activity, could eventually predict whether subjects falsely recognize non-experienced events.     

Frontal lobe activation during object permanence: data from near-infrared spectroscopy

The ability to create and hold a mental schema of an object is one of the milestones in cognitive development. Developmental scientists have named the behavioral manifestation of this competence object permanence. Convergent evidence indicates that frontal lobe maturation plays a critical role in the display of object permanence, but methodological and ethical constrains have made it difficult to collect neurophysiological evidence from awake, behaving infants. Near-infrared spectroscopy provides a noninvasive assessment of changes in oxy- and deoxyhemoglobin and total hemoglobin concentration within a prescribed region. The evidence described in this report reveals that the emergence of object permanence is related to an increase in hemoglobin concentration in frontal cortex.     

度洛西汀联合喹硫平治疗老年期抑郁症对照研究

目的 探讨度洛西汀联合喹硫平治疗老年期抑郁症的临床疗效和安全性.方法 将52例老年期抑郁症患者随机分为两组,每组26例,研究组口服度洛西汀联合喹硫平治疗,对照组单用度洛西汀治疗,观察6周.采用汉密顿抑郁量表、临床疗效总评量表-病情严重程度分量表评定临床疗效,副反应量表评定不良反应.结果 治疗6周末研究组总有效率为84.6%,对照组为57.7%,研究组总有效率显著高于对照组(χ2=4.59,P＜0.05).两组不良反应主要表现为乏力、恶心、头晕、失眠、体位性低血压等;研究组失眠发生率显著高于对照组(P＜0.05),嗜睡、排尿困难、体位性低血压、心电图异常发生率均显著低于对照组(P＜0.05或0.01).结论 度洛西汀联合喹硫平治疗老年期抑郁症疗效显著,较单用度洛西汀起效更快,安全性高,依从性好.     

Muscle metabolism in patients with polymyositis simultaneously evaluated by using 31P-magnetic resonance spectroscopy and near-infrared spectroscopy

Simultaneous measurements of muscle energy metabolism using (31)P-magnetic resonance spectroscopy ((31)P-MRS) and the kinetics of muscular oxygen metabolism using near-infrared spectroscopy (NIRS) were conducted in polymyositis (PM) patients. The subjects were 12 PM patients (age 45 +/- 12 years) and 12 normal controls (age 41 +/- 12 years). The muscle phosphocreatine (PCr) index and intracellular pH (pHi) were determined with (31)P-MRS and the changes in intramuscular oxygenated (oxy-Hb), deoxygenated (deoxy-Hb), and total haemoglobin (total Hb) were evaluated with NIRS . The pHi and PCr index before steroid therapy in PM patients were significantly lower during exercise than in normal controls, and their recovery was statistically significantly delayed compared with the controls. The pattern of changes in NIRS over time before steroid therapy in PM patients differed from that in normal controls. There were smaller changes in deoxy-Hb and oxy-Hb during exercise, and total Hb decreased during exercise. In contrast, the kinetics of muscular metabolism after steroid therapy showed changes similar to those seen in normal controls. Simultaneous (31)P-MRS and NIRS measurements to determine the kinetics of muscular metabolism are expected to be useful as a noninvasive approach for the evaluation of treatment effects in PM patients.     

Determination of blood flow in the finger using near-infrared spectroscopy

Wavelengths in the near-infrared range have much better penetrance in organic substances than visible light. We used near-infrared spectroscopy to determine non-invasively blood flow in the fingertip. We used laser Doppler technology to measure skin blood flow as a comparison procedure. We performed several manoeuvres to change blood flow. These included restriction of flow, thermal stimulation and post-occlusion hyperaemia. Near-infrared measurements had coefficients of variation of 10–15% at the various wavelengths, contrasting with variability of 30–40% with laser Doppler measurement. With restriction of blood flow, there was a downward shift in the absorbance curve. With thermal stimulation and with post-occlusion hyperaemia, there was a rise in the curve. The flow-induced shifts in the absorbance curve were particularly pronounced in the range of 850–970 nm. The correlation between absorbance values and laser Doppler-determined blood flow was also highest in this range, averaging about 0·69 (n = 625). Near-infrared spectroscopy can therefore be used to scan the fingertip. The absorbances obtained do reflect changes in blood flow. There is a correlation with skin blood flow, although near-infrared measurements are affected by blood flow in the full breadth of the finger, not just the skin. We can measure this blood flow with significant reproducibility. It may be possible to use near-infrared spectroscopy to measure the concentration of individual blood components.