牙髓痛时大脑皮层激活区定位方法的初步探讨

目的:探讨将功能性磁共振成像(fMRI)技术运用于牙髓冷刺激痛及期待的大脑皮层定位研究的可行性.方法:选取右利手右上颌第一双尖牙牙髓冷刺激痛患者1名,排除口内的其它牙髓病变及金属充填、修复体.采用软管注射冷水装置及组块设计方法,采集全脑fMRI扫描数据,并用SPM2软件包进行结果的数据分析获得脑功能图像.结果:在对疼痛的期待过程中,右侧额上回、右侧中央前回、右顶下小叶和顶叶缘上回、左颞上回可见激活.冷刺激引起右上颌牙疼时,双侧中央前回、右额下回、左额中下回、左颞上下回、左岛叶可见激活.冷刺激同一患者左上颌同名牙时,双侧中央前回、右侧中央后回有激活,激活范围和强度有显著不同.结论:fMRI技术在合适的刺激条件下,可用于探讨牙痛与脑功能关系的研究,其脑激活区还有待于进一步实验结果.     

颌面部触觉及热刺激痛时大脑皮层激活区定位方法的初步探讨

目的:探讨将功能性磁共振成像(fMRI)技术运用于颌面部触觉及痛觉的大脑皮层定位研究的可行性。方法:选取右利手正常志愿者1名,分别采用触觉、热痛刺激颌面部及组块设计方法,采集全脑fMRI扫描数据,并用SPM99软件包进行结果的数据分析获得脑功能成像。结果:触觉刺激任务引起左侧顶叶中央后回(BA3)、右侧顶叶中央后回(BA1)、左额叶中央前回、右侧颞上回激活。热刺激痛任务可见右侧顶叶中央后回、右额叶中央前回、左侧额叶中央前回、左额上回、左前扣带回、左边缘叶前扣带回激活。结论:fMRI技术在合适的刺激条件下,可用于探讨颌面部触觉、疼痛与脑功能关系的研究,其脑激活区还有待于进一步实验结果。     

口腔内冷水刺激反应的功能性磁共振成像研究

目的:探讨口腔冷水刺激时的大脑皮层区定位。方法:选取13名健康志愿者,4℃冷水刺激,并以室温水组作为空白对照。利用水传递装置自上下唇进入口腔黏膜水刺激,并采用水刺激信号减静息信号的组块设计方法,采集冷水刺激时全脑血氧水平依赖对比的fMRI扫描数据,并用SPM99软件包进行结果的数据分析。结果:激活双侧眶额皮层(orbitalfrontal cortex,OFC)(BA11)、BA44、口腔躯体感觉运动皮层、顶叶、前运动皮层PMC(BA6)。右侧舌回、扣带回、颞叶和左侧枕叶的楔叶激活。结论:1.口腔冷水刺激可以激活大脑皮层的相关区;2.冷水刺激激活与口腔内水愉快行为评估有关的OFC。     

口腔内水刺激的脑功能成像研究

目的利用功能性磁共振成像（fMRI）技术探讨高级中枢如何解读口腔内水刺激。方法选取13名健康志愿者,利用自制水传递装置将水注入口腔内,采用水刺激信号减静息信号的组块设计方法,以SPM99软件分析数据获得口腔内水刺激与静息状态对比的fMRI脑功能图像。结果水刺激口腔时,广泛激活左侧岛叶、罗兰多区（BA1/3/4/43）、右侧眶额皮层（BA11）、额中回（BA10）,其次是右侧顶叶（BA7）、中脑红核、扣带回和左侧额下回、岛叶（BA13）。结论口腔内水刺激引起口腔感觉运动代表区的激活,还引起其他相关脑区激活;在研究味觉和温度觉的神经解剖研究过程中需要控制水和其他非味觉因素。     

触觉刺激三叉神经上颌支面部支配区的功能性MRI研究

目的:观察触觉刺激三叉神经上颌支(简称V2)面部支配区引起的大脑中枢反应区。方法 :选取8名健康志愿者,用棉签刺激右侧面部三叉神经上颌支的支配区,采用触觉刺激减静息的组块设计方法,采集全脑血氧水平依赖对比的功能性MRI扫描数据。结果:脑激活区为左侧初级躯体感觉皮质(BA3)、岛叶/SII、BA22、BA45,右侧BA40、BA9、BA38、BA41。结论:对侧初级躯体感觉皮质、岛叶/SII和颞上回,同侧中央后回、颞下回和颞横回及双侧前额皮质是面部V2区触觉刺激激活的脑部功能区。     

疼痛性冷刺激和非痛温热刺激口腔时对大脑皮层反应强度的影响

目的 探索疼痛性冷刺激和非痛温热刺激口腔时对大脑皮层反应强度的影响。方法 选取6名健康志愿者,采用组块设计方法,利用水传递装置分别用冷水（4 ℃）和温水（23 ℃）刺激其口腔,采集全脑血氧水平依赖对比的功能性磁共振成像（fMRI）扫描数据进行分析。结果 冷水和温水刺激共同激活了左侧中央前后回、岛叶/岛盖、前扣带回（ACC）、眶额皮层,右侧中脑红核和丘脑。此外,冷水刺激还激活了左侧枕叶、运动前皮层布罗德曼分区（BA）6、右侧BA44、舌回,以及顶叶BA7和BA40,初级躯体感觉皮层SⅠ。疼痛性冷水刺激激活的脑区多于无痛温水,而激活脑区的强度小于温水,但是疼痛冷水刺激在ACC的激活强度明显大于无痛温水刺激。结论 大脑皮层对疼痛性冷刺激口腔时反应的脑区的激活强度小于非痛性温热水刺激,但是ACC脑区的激活强度大于非痛性温水刺激。     

正畸治疗对微笑面孔审美认知影响的功能磁共振研究

目的采用脑功能磁共振成像(fMRI)技术探究正常成人对正畸治疗前后面孔审美认知的脑激活模式。方法以96张不同吸引力正畸治疗前后的微笑面孔作为刺激材料,在20名健康志愿者对微笑面孔进行审美评价的同时利用fMRI进行全脑数据采集,用SPM8软件处理功能成像数据,分析不同面孔刺激的脑区激活情况。结果枕叶、颞叶、梭状回等脑区参与了正畸前后面孔审美的认知过程。对于高吸引力组面孔,正畸前较正畸后显著激活右侧额内侧回、右侧额中回、右侧中央前回;对于低吸引力组,正畸前较正畸后显著激活右侧旁中央小叶、右侧顶下小叶、左侧颞中回、双侧扣带回、左侧楔前叶。结论多个功能脑区协同参与了正畸前后面孔的审美认知过程,正畸前面孔相对于正畸后面孔显著引起认知、注意、情绪相关脑区的激活改变。     

腭裂患者异常语音感知中枢神经响应的初步研究

目的 基于任务态功能性磁共振成像技术(functional magnetic resonance imaging, fMRI),研究腭裂患者感知异常语音的神经激活模式。方法 采用组块设计,在16例腭裂患者和20名正常听者执行声门停顿音、高鼻音、正常语音三类听觉刺激的感知任务时,进行功能性磁共振扫描,统计分析腭裂组和正常组在感知不同语音刺激时脑激活模式的差异。结果 (1)腭裂组与正常组在感知声门停顿音时,右侧额中回出现显著的激活差异(FDR校正,P<0.05);(2)腭裂组在不同语音刺激下,脑激活反应存在差异,声门停顿音在右侧梭状回、枕上回、颞中回、颞上回、角回和中央前回等脑区的激活反应显著高于其他语音刺激(FDR校正,P<0.05)。结论 腭裂组与正常组在感知以声门停顿音为例的异常语音时,其神经激活模式存在显著差异,出现显著的右侧半球言语相关脑区激活,提示腭裂患者可能存在言语功能的代偿反应。     

人脑对牙髓冷刺激痛反应的功能性磁共振成像研究

目的:探讨牙髓冷刺激痛时的大脑皮层兴奋位点。方法:选取右上颌第一前磨牙冷刺激痛患者(P-R)及正常对照(N-R)各8名,采集右上颌第一前磨牙冷水刺激时全脑血氧水平依赖反应(BOLD)对比的fMRI扫描数据,利用SPM2软件包进行数据分析并产生脑功能图像。结果:P-R组右侧激活最强的岛叶/SII在左侧激活较低,右侧基底节、扣带回、中脑红核的强度都略高于左侧,BA7、丘脑为右侧单侧激活。而左侧激活最强的Broca运动语言区BA44、MII/PMC/BA4,6在右侧没有激活。N-R组激活较强的有SI/MI、MII/PMC、基底节、BA7、BA40。结论:牙痛时前运动皮质、辅助运动皮质和Broca运动语言区的激活较强,在多数皮层为双侧激活,与躯体痛相比某些脑区在同侧大脑半球的激活比对侧更强。     

下颌第三磨牙拔除后疼痛患者的脑激活区研究

目的：应用PET方法研究下颌第三磨牙拔除4h后疼痛状态下的脑激活区分布,并推测不同分区的参与状况及其作用。方法：筛选口颌系统功能及形态正常的志愿者6例,设拔牙前一天利多卡因阻滞麻醉4h后的PET检查为对照组。设拔牙4h后感到明显疼痛时（VAS≥5）的PET检查为实验组。SPM2分析。结果：左侧大脑豆状核、BA7、BA8、BA9、BA10、BA18、BA19、BA43、BA47区域,有明显的代谢升高。结论：豆状核、额上回、额中回、额下回、中央后回、楔前叶、枕叶楔叶、枕中回等是被拔牙活动所激活的脑区。     

Interindividual differences in the perception of dental stimulation and related brain activity

For identical diagnoses in the trigeminal innervation territory, individual differences have been clinically observed among the symptoms reported, such as dysesthesia and pain. Different subjective perceptions of unpleasantness and pain intensity may have different cortical substrates. The aim of this study was to identify brain areas in which activation depends on the subjective perception (intensity and unpleasantness) of electric dental stimulation. Electrical stimuli of increasing intensity were applied to maxillary canines in 14 healthy volunteers. Ratings for stimulus intensity and unpleasantness perceived across the stimulation session were reported postscan on 11-point numerical scales. The rating values were then included as covariates in the functional magnetic resonance imaging (fMRI) group analysis. Interindividual differences of intensity ratings were reflected in differential activity of the following brain areas: superior parietal lobule, superior temporal gyrus/anterior insula, inferior and middle temporal gyrus, lingual gyrus, anterior cingulate, and caudate nucleus. Differences related to unpleasantness ratings were reflected in the lingual gyrus. In conclusion, differences of perceived intensity between individuals are reflected in the differential activity of a set of brain areas distinct from those regions, reflecting rating differences of unpleasantness.     

Combined fMRI and MRI movie in the evaluation of articulation in subjects with and without cleft lip and palate.

OBJECTIVE: This study was undertaken to explore the application of functional magnetic resonance imaging (fMRI) and MRI movies in the evaluation of articulatory function in subjects with and without cleft lip and palate (CLP). DESIGN: The authors examined brain activation and the dynamic movement of articulators during bilabial and velar plosives using fMRI and MRI movies. SUBJECTS: Two subjects, one with unilateral cleft lip and palate (UCLP) and one with bilateral cleft lip and palate (BCLP), and 12 non-CLP volunteers. RESULTS: Activation foci were found in the precentral gyrus, thalamus, and cerebellum in non-CLP volunteers. In comparison, similar regions were activated in the UCLP subject during both plosives, whereas the regions activated in the BCLP subject were different, particularly during the velar plosive. The dynamic movement of articulators in the UCLP subject was comparable to that in a non-CLP volunteer but different from that in the BCLP subject. CONCLUSIONS: The results suggest that these two MRI modalities may be a promising evaluation methodology for articulatory function in CLP from central and peripheral perspectives.     

Effect of articulatory rehabilitation after oral cancer surgery on higher brain activation

The present study aimed to verify the importance of postoperative articulatory rehabilitation in patients with oral cancer and to clarify the neurological changes underlying articulatory functional recovery. A longitudinal assessment of oral function and accompanying brain activity was performed using non-invasive functional magnetic resonance imaging (fMRI). We assessed 13 patients with cancers of the tongue and oral floor before and after ablative surgery. Articulatory function was assessed preoperatively and postoperatively using a conversation intelligibility test and the Assessment of Motor Speech for Dysarthria test. Patients also performed a verbal task during fMRI scans. The assessments were then repeated after the patients had undergone 4–6 months of articulatory rehabilitation therapy. Compared to pretreatment levels, articulatory rehabilitation resulted in a significant increase in activation in the supplementary motor cortex, thalamus, and cingulate cortex. The present study offers a quantitative assessment of the effects of speech rehabilitation by investigating changes in brain activation sites.     

偏侧咀嚼对紧咬牙运动时海马旁回激活影响的探索

目的探索偏侧咀嚼对紧咬牙运动时脑功能活动的影响。方法选取左、右侧偏侧咀嚼患者各7例，在紧咬牙运动时采集全脑血氧水平依赖对比的功能性磁共振成像（functional magnetic resonance imaging，fMRI）扫描数据。结果7例左侧偏侧咀嚼患者中有4例出现海马旁回的激活，而右侧偏侧咀嚼患者均未见海马旁回的激活。结论发现了左侧偏侧咀嚼患者紧咬牙运动可激活与人类学习记忆能力有重要关系的海马旁回的现象。     

单侧咀嚼的功能性核磁成像研究

目的 :观察左侧咀嚼运动时脑功能活动情况 ,探索功能性核磁成像方法用于咀嚼功能和脑功能关系研究的可行性。方法 :应用功能性核磁成像方法 ,对 10名健康志愿者左侧咀嚼运动时脑功能活动情况进行检测。结果 :左侧咀嚼运动时不同个体之间脑激活区存在一定的差异 ,脑激活区包括 :右侧运动前区、右侧岛叶、右侧前额叶皮层、左侧中央前回、左右侧枕叶。结论 :功能性核磁成像方法可用于咀嚼功能和脑功能关系的研究。单侧咀嚼的大脑皮层调控可能具有对侧半球优势。脑激活区在单侧咀嚼中的作用还有待进一步的探讨