原发性痛经患者灰质体积改变与临床指标的相关性: 基于体素形态学测量技术

目的  基于体素形态学测量技术探究原发性痛经患者脑灰质体积改变及其与临床量表评分间的相关性。方法  收集符合纳入标准的41例原发性痛经患者和41例健康对照者在月经来潮的第1~3天内进行高分辨率T1结构像扫描,并且填写痛经程度量表、COX痛经症状量表、焦虑自评量表、抑郁自评量表。采用SPM8软件在全脑水平比较灰质体积,观察两组灰质体积显著变化的脑区。结果  原发性痛经患者较健康对照脑灰质体积缩小,差异脑区主要包括：左侧眶部额中回、左侧前扣带回、右侧前扣带回（P < 0.001）,未发现灰质体积明显增加的脑区。痛经组和健康组在痛经程度量表、COX痛经症状量表、焦虑自评量表、抑郁自评量表评分的差异有统计学意义（P < 0.001）。左侧前扣带回与痛经程度量表、COX痛经症状量表、焦虑自评量表、抑郁自评量表评分存在负相关关系。结论  基于体素形态学测量技术可以准确评估原发性痛经患者脑灰质微结构改变,这些灰质体积缩小的脑区主要涉及疼痛传递、处理及情绪调节相关的脑区,其灰质体积的变化在原发性痛经疼痛的发生及持续中可能有着重要作用。     

前庭性偏头痛患者基于体素的脑灰质体积研究

目的 采用基于体素的形态分析法(voxel-based morphological analysis,VBM)分析前庭性偏头痛(vestibular migraine,VM)患者大脑灰质体积改变区域,以期提供临床病理生理方面的新思路.材料与方法 严格按照纳入标准及排除标准,招募了17例VM患者及20例健康对照组.所有受...     

基于体素的形态学测量在认知障碍相关疾病中的研究进展

认知障碍(cognitive impairment)指患者大脑存在信息处理和存储的异常,主要症状包括记忆力减退、社交及人格方面的障碍。目前认知障碍相关疾病的发病率逐年增高,严重影响患者日常工作、学习和生活。随着MRI技术的发展,特别是基于体素的形态学测量(voxel-based morhpometry,VBM)技术的应用,认知障碍相关疾病的患者脑体积改变与其认知功能的相关性逐渐成为人们研究的热点,这一相关性有望成为临床上预测认知功能障碍的早期生物标志物。因此通过研究认知障碍相关疾病患者疾病进展过程中脑体积的改变,以期早期发现该类患者认知功能的减退,采取措施延缓其进展。该文对VBM技术在认知障碍相关疾病中的研究进展进行综述。     

基于自动分割技术联合基于体素的形态学观察帕金森病脑灰质结构

目的 探讨基于自动分割技术联合基于体素的形态学(VBM)观察帕金森病(PD)患者全脑灰质异常区域及分布特征的应用价值。方法 基于自动分割技术,应用FIRST工具对29例PD患者(PD组)及30名健康人(对照组)的T1图像皮层下灰质结构精确分割,对比两组各灰质结构体积。并应用VBM方法对两组脑灰质图像进行比较。结果 两组右侧壳核皮层下灰质体积差异有统计学意义(t=10.201,P<0.05)。与对照组比较,PD组脑灰质体积(右侧初级运动皮层,双侧额叶、边缘叶、部分左侧小脑后叶、右侧小脑前叶、右侧小脑后叶、右侧颞叶、顶叶、壳核及左侧枕叶)广泛减少,部分左侧小脑后叶体积增加,两侧半球脑体积缺失不对称(右侧大于左侧)。结论 通过FIRST工具可精确分割并直接计算皮层下灰质结构体积,应用VBM技术可定量分析脑结构形态学异常;二者结合可较全面地表现PD脑灰质体积广泛减少的形态学特点。     

基于体素的形态学分析在认知障碍领域的应用

发现阿尔茨海默病(AD)早期阶段的生物标志物有利于提高AD诊断的准确性及早期诊断AD。随着神经影像及分析方法的发展,基于体素的形态学分析方法(VBM)因其可重复性及准确性引起了人们的重视,利用VBM方法研究AD的灰质体积,可通过神经结构体积的改变预测AD的风险,并发现与AD相关的灰质体积改变的部位,以利于对AD潜在的病理生理学机制的理解,为治疗和预防AD提供帮助。本文结合国内外最新研究进展,就VBM在认知障碍领域的应用做一综述。     

基于体素的形态学方法评价急性脊髓损伤患者脑灰白质体积改变

目的 采用基于体素的形态学（VBM）分析方法探讨急性脊髓损伤（SCI）患者脑灰白质体积改变。方法 对16例急性SCI患者（受伤时间< 30天,SCI组）和20名年龄、性别匹配的正常志愿者（对照组）行脑3D T1W序列扫描,采用VBM分析方法比较2组脑灰白质体积,获得脑灰质体积差异有统计学意义的脑区;测量或计算脑组织体积（BTV）、全脑体积（TIV）、脑灰质体积（GMV）、脑白质体积（WMV）、脑脊液体积（CSFV）和脑灰质分数（GMF）、脑白质分数（WMF）和脑组织分数（BTF）。结果 与对照组相比,SCI组双侧下额叶、岛叶、内侧前额叶及前扣带皮质、小脑后叶灰质体积减小,内囊水平皮质脊髓束体积减小。SCI组与对照组间GMV、WMV、CSFV、BTV、TIV及GMF、WMF、BTF差异均无统计学意义（P均> 0.05）。结论急性SCI导致远隔部位情绪处理相关脑区灰质及皮质脊髓束萎缩,有助于探讨急性SCI对大脑结构产生影响的作用机制。     

基于体素形态学观察帕金森病患者全脑灰质:2年纵向MR研究

目的 探讨无痴呆症状的帕金森病(PD)患者全脑灰质结构随时间变化的特征。方法 采用T1W三维磁化准备快速梯度回波序列对20例无痴呆症状的PD患者(PD组)进行间隔2年的随访。纳入25名年龄和性别匹配的健康体检者作为对照组,采用SPM8进行基于体素的形态学分析技术的数据处理。结果 与对照组比较,PD组灰质萎缩区域包括双侧颞中回及小脑后叶;纵向比较发现,PD患者灰质萎缩区域集中在左侧额中回和扣带回、左侧顶下小叶及右侧小脑前叶和小脑蚓。结论 PD患者大脑灰质改变集中在颞叶和小脑,但随病情发展,左侧额顶叶和右侧小脑更为明显;这些特征性形态学变化可能是PD患者出现运动功能障碍的结构基础。     

帕金森病轻度认知功能障碍:基于体素的全脑灰质形态学研究

目的采用基于体素的形态学测量方法,分析帕金森病(PD)伴轻度认知功能损害(MCI)患者全脑灰质结构的变化。方法利用3.0T MR仪对22例伴MCI的PD患者(PD伴MCI组)、21例认知功能正常的PD患者(单纯PD组)及20名健康对照(NC组)进行T1W扫描。采用SPM8为基础的VBM8工具箱进行数据处理。结果与NC组比较,PD伴MCI组脑灰质萎缩见于双侧额叶、左侧颞叶、双侧枕叶、双侧小脑、左侧后扣带回及左侧海马区域;单纯PD组脑灰质萎缩集中出现于左侧额叶、颞叶。与单纯PD组相比,PD伴MCI组左侧颞中回和海马旁回出现灰质萎缩。结论伴有MCI的PD患者的脑灰质结构改变范围比不伴MCI者更广,提示PD患者认知功能改变存在脑形态结构水平的异常。     

缺血性脑白质疏松患者基于体素的脑结构特征研究

目的:用基于体素的形态学分析(VBM)方法,探讨缺血性脑白质疏松(LA)患者大脑灰质体积是否存在异常及其分布特征。方法:LA认知功能障碍患者34例和年龄、性别、受教育程度相匹配的正常老年人23名(对照组)纳入研究。所有被试均进行了认知功能测查和3.0T磁共振影像检查,根据认知量表评分结果将LA组分为LA轻度认知功能障碍(LA-MCI)组和LA血管性痴呆(LA-VD)组。采用VBM对所有被试大脑灰质密度和灰质体积进行基于体素检测和比较,分析LA认知功能障碍患者大脑灰质密度减少区域、分布特征及其临床意义。结果:与对照组相比,LA-VD组左前额叶及黑索回大脑灰质密度减低(P<0.05);LA-MCI组右中央前后回及左顶上回、左尾状核区灰质密度减低(P<0.05);与LA-MCI组比较,LA-MCI组左额中回和右额中回灰质密度减低(P<0.05)。LA认知功能障碍患者执行功能分数与左额中叶灰质体积显著相关(P<0.05)。结论:LA患者存在广泛的大脑灰质萎缩,执行功能下降与其密切相关。     

阿尔茨海默病脑灰质体积异常的MRI研究

目的研究阿尔茨海默病(AD)患者MRI图像脑灰质萎缩的模式。方法对19例AD患者和20例正常老年对照者行MRI扫描,通过优化的基于体素的形态学(optimizedvoxelbasedmophometry,OVBM)分析方法,分析AD患者全脑和局部脑灰质的体积异常。结果AD患者全脑灰质体积相对于正常对照者明显降低(P=0.0048),双侧海马、双侧丘脑、双侧颞上回和左侧颞中回体积明显减少(多重校正后,相当于P<0.05)。结论AD患者的全脑灰质体积明显降低,局部区域明显萎缩。     

Regional gray and white matter volume associated with Stroop interference: evidence from voxel-based morphometry

During Stroop tasks, subjects experience cognitive interference when they resolve interferences such as identifying the ink color of a printed word while ignoring the word's identity. Stroop paradigms are commonly used as an index of attention deficits and a tool for investigating the functions of the frontal lobes and other associated structures. Despite these uses and the vast amount of attention given to Stroop paradigms, the regional gray matter volume/regional white matter volume (rGMV/rWMV) correlates of Stroop interference have not yet been identified at the whole brain level in normal adults. We examined this issue using voxel-based morphometry in right-handed healthy young adults. We found significant negative relationships between the Stroop interference rate and rGMV in the anterior cingulate cortex (ACC), right inferior frontal gyrus, and cerebellum. Furthermore, we found relationships between the Stroop interference rate and rWMV in bilateral anatomical clusters that extended around extensive WM regions in the dorsal part of the frontal lobe. These findings are the first to reveal rGMV/rWMV that underlie the performance of the Stroop task, a widely used psychological paradigm at the whole brain level. Of note, our findings support the notion that ACC contributes to Stroop performance and show the involvement of regions that have been implicated in response inhibition and attention.     

Visceral sensitivity correlates with decreased regional gray matter volume in healthy volunteers: A voxel-based morphometry study

Regional changes in brain structure have been reported in patients with altered visceral sensitivity and chronic abdominal pain, such as in irritable bowel syndrome. It remains unknown whether structural brain changes are associated with visceral sensitivity. Therefore, we present the first study in healthy individuals to address whether interindividual variations in gray matter volume (GMV) in pain-relevant regions correlate with visceral sensitivity. In 92 healthy young adults (52 female), we assessed rectal sensory and pain thresholds and performed voxel-based morphometry (VBM) to compute linear regression models with visceral sensory and pain thresholds, respectively, as independent variable and GMV in a priori-defined regions of interest (ROIs) as dependent variable. All results were familywise error (FWE) corrected at a level of P_FWE < .05 and covaried for age. The mean (±SEM) rectal thresholds were 14.78 ± 0.46 mm Hg for first sensation and 33.97 ± 1.13 mm Hg for pain, without evidence of sex differences. Lower rectal sensory threshold (ie, increased sensitivity) correlated significantly with reduced GMV in the thalamus, insula, posterior cingulate cortex, ventrolateral and orbitofrontal prefrontal cortices, amygdala, and basal ganglia (all P_FWE < .05). Lower rectal pain threshold was associated with reduced GMV in the right thalamus (P_FWE = .051). These are the first data supporting that increased visceral sensitivity correlates with decreased gray matter volume in pain-relevant brain regions. These findings support that alterations in brain morphology not only occur in clinical pain conditions but also occur according to normal interindividual variations in visceral sensitivity.     

原发性三叉神经痛灰质体积变化的磁共振形态学研究

目的应用基于体素的形态学分析方法检测原发性三叉神经痛患者是否存在灰质体积改变,探索中枢神经系统在其疼痛处理中的作用。材料与方法对19例右侧三叉神经痛患者和22例年龄性别匹配的正常对照进行磁共振三维T1结构像扫描(3D-T1BRAVO),应用基于体素形态学分析(voxel-based morphometry,VBM)检测三叉神经痛患者全脑灰质体积的变化,探索各变化的中枢神经系统脑区在疼痛处理中的作用,并分别分析其体积变化与疼痛程度及病程的相关性。结果与正常对照组相比,病例组左侧前扣带回灰质体积明显减少;右侧额上回、右侧岛叶、右侧壳核、双侧小脑前叶灰质体积明显增加,左侧前扣带回体积变化与疼痛病程呈负相关性。结论三叉神经痛患者存在中枢神经系统灰质体积变化,左侧前扣带回体积与疼痛病程呈负相关性,这些存在差异的中枢神经系统脑区在三叉神经痛患者疼痛的形成及慢性状态的维持中可能有重要作用,提示探索三叉神经痛的中枢处理机制有益于新的治疗方法的研发。     

精神分裂症患者大脑灰质结构异常的VBM初步分析

目的评价基于体素的形态学分析法(VBM)分析精神分裂症大脑灰质结构的价值。方法采用GE Signa Twin Speed1.5T超导型MRI成像系统,对9例精神分裂症患者和9例年龄、性别与之相匹配的正常人行全脑扫描,获取16～18层脑结构MRT1图像。数据分析采用以SPM2软件包为基础的全自动VBM技术进行处理。结果与正常对照组比较,精神分裂症患者灰质明显减少区域在双侧前扣带回、前额叶、右侧颞上回(P<0.005),且大脑灰质减少具有不对称性,前额区偏侧化系数(AIs)为 0.19,颞区为-0.50。灰质明显增多的区域在右前额叶与右枕区、左顶下小叶(P<0.005),也具有不对称性,前额区AIs为-0.77,顶叶 1.00,枕区为-0.73。结论精神分裂症患者大脑灰质结构异常。VBM法具有简便、自动化的特点,在精神分裂症脑形态结构研究方面前景广阔。     

Changes in regional gray matter volume in women with chronic pelvic pain: a voxel-based morphometry study

Chronic pelvic pain (CPP) is a highly prevalent pain condition, estimated to affect 15%-20% of women in the United States. Endometriosis is often associated with CPP, however, other factors, such as preexisting or concomitant changes of the central pain system, might contribute to the development of chronic pain. We applied voxel-based morphometry to determine whether women with CPP with and without endometriosis display changes in brain morphology in regions known to be involved in pain processing. Four subgroups of women participated: 17 with endometriosis and CPP, 15 with endometriosis without CPP, 6 with CPP without endometriosis, and 23 healthy controls. All patients with endometriosis and/or CPP were surgically confirmed. Relative to controls, women with endometriosis-associated CPP displayed decreased gray matter volume in brain regions involved in pain perception, including the left thalamus, left cingulate gyrus, right putamen, and right insula. Women with CPP without endometriosis also showed decreases in gray matter volume in the left thalamus. Such decreases were not observed in patients with endometriosis who had no CPP. We conclude that CPP is associated with changes in regional gray matter volume within the central pain system. Although endometriosis may be an important risk factor for the development of CPP, acting as a cyclic source of peripheral nociceptive input, our data support the notion that changes in the central pain system also play an important role in the development of chronic pain, regardless of the presence of endometriosis.     

早期盲人大脑灰质不对称的基于体素脑形态学初步研究

目的初步探讨视觉剥夺对人脑灰质结构不对称的影响。方法早期失明的成年盲人组（14例，右利手）与正常对照组（16例，右利手，年龄、性别匹配）在1．5T磁共振成像系统下获取全脑高分辨率的脑结构像（T1W）。通过基于体素的脑形态学（VBM）方法比较两组间脑灰质不对称的异同。结果与正常对照相比，早期盲人的一些脑区呈灰质左侧化增高，包括额叶（BA 10／8）、体感区（BA 3）及颞极（BA 43），以及枕叶视皮层（中枕回，BA 18／19）灰质右侧化增高。结论早期盲人大脑多个系统发生了结构重组，可以表现为灰质不对称的变化。