卒中后抑郁的功能性磁共振成像和结构性磁共振成像研究进展

目前,卒中后抑郁(PSD)发病机制不明。结构性及功能性磁共振成像为PSD相关临床研究提供了丰富且有价值的依据,可反映大脑形态、功能的变化,从而为早期发现并诊断、治疗PSD提供帮助。目前,抑郁的相关研究主要集中在原发性抑郁,而对于PSD的影像学相关研究相对较少。本文就PSD的结构性和功能性磁共振成像研究进展进行综述。     

功能性磁共振成像在急性脑缺血中的研究

功能性磁共振成像是目前观察急性脑缺血较为先进的一种方法,不但可明确病灶发生的部位、病灶大小,而且可探查早期脑功能状态以及相关病理生理改变。本文着重介绍这项技术的成像基本原理,阐述它的初步临床应用。     

针刺健康人功能性磁共振成像研究进展

功能性磁共振成像是近年来在常规磁共振成像技术基础上发展起来的能够实时显示脑功能变化的新技术,具有无创伤性、无放射性、可重复性、较高的时间和空间分辨率、可准确定位脑功能区等特点,已经成为迄今为止研究针刺作用机制的最佳工具之一,被广泛应用到针刺穴位特异性、穴位配伍、针刺手法等针灸学研究的各个方面。本文综述了针刺正常人功能性磁共振成像研究进展及存在问题和应用前景。     

注意缺陷多动障碍功能性脑磁共振成像研究进展

注意缺陷多动障碍（attention-deficit／hyperactivity disorder,ADHD）是以发育过程中出现的注意力下降、冲动、运动增多为特征的一组征候群,学龄儿童发病率大约为5％,部分人症状一直持续到成年。ADHD在各个年龄段均有较高的发病率,明确其发病机制对疾病的诊断、治疗尤为重要。在过去的几十年中,功能性脑成像技术获得了飞速的发展,为探讨ADHD的神经生物学机制、治疗药物的神经学原理打开了一个前所未有的窗口。     

功能性磁共振成像技术针刺临床应用概况

近年来随着医学影像学的发展．国内外许多学者利用功能性磁共振成像（functionalmagneticresonanceimaging,fMRI）技术,对针刺不同穴位的脑功能成像及临床应用进行了一系列的研究,为促进针刺治疗疾病机制的探讨,提供了一定的可视性依据。笔者分别对针刺健康人上肢穴位、下肢穴位、上下肢配穴的磁共振脑功能成像以及其在针灸临床应用的概况,做如下综述。     

功能性磁共振成像观察针刺对脑活动效应的应用进展

功能性磁共振成像（Functional Magnetic Resonance Imaging,FMRI）是当代医学影像技术应用于脑神经科学研究最为迅速的领域之一,是目前人类所掌握的唯一无侵入、无创伤、可精确定位的人脑高级功能研究手段。在针刺治疗研究中,FMRI观察证实了穴位与脑结构的相对特异性联系及不同针刺方法对脑活动的效应,同时FMRI还发现针刺激活多个脑功能区构成的网络系统产生生理效应,从而为针刺作用的机制提供客观的、确凿的、有统计学意义的证据,进一步为传统针灸学的传承和发展提供科学的理论基础。     

与吞咽功能相关的脑皮质中枢的功能性磁共振成像研究进展

中枢神经系统疾病如中风、阿尔茨海默病、帕金森病和创伤等常导致显著的吞咽功能障碍。国外文献报道卒中后吞咽障碍的发生率为37％～78％，国内报道为62．5％，吞咽障碍可造成吸人性肺炎、营养不良和脱水、窒息等各种并发症，甚至可危及生命。虽然多数脑卒中患者在6个月后能恢复卒中前的饮食，而电视透视检查显示，有一半以上患者仍遗留有不同程度吞咽障碍。研究显示，     

原发性中枢神经系统淋巴瘤磁共振及功能性成像特点

目的 分析免疫功能正常人原发性中枢神经系统淋巴瘤的传统MRI征象、弥散加权成像(DWI)、灌注加权成像(PWI)及氢质子磁共振波谱(1H-MRS)表现,探讨其诊断价值.方法 回顾分析12例经手术病理证实的原发性中枢神经系统淋巴瘤的MRl征象.结果 12例患者均为B细胞淋巴瘤,共检出13个结节,11例为单发,1例为多发.病灶T1WI呈低或等信号影,T2WI呈等、稍高、高信号影,DWI呈高、低信号影;病灶的边界较清晰,周围可见轻中度水肿;病灶多呈明显均匀强化及"缺口征"、"尖突征";1H-MRS表现为N-乙酰天门冬氨酸(NAA)峰中度降低,胆碱(Cho)峰升高,肌酸(Cr)峰轻度降低,并可见巨大的脂质(Lip)峰.灌注加权成像提示病灶为低灌注结节.结论 传统磁共振成像与弥散加权成像、灌注加权成像、1H-MRS的联合应用可以提高磁共振对原发性中枢神经系统淋巴瘤的诊断率.     

穴位功能特异性的功能性磁共振成像研究现状

正穴位特异性研究是目前针灸研究领域的热点与难点,穴位特异性包括两个方面,一是穴位的结构特异性,即穴位具有特定的组织结构和物理生物属性;二是穴位的功能特异性,即穴位的效应特异性。其中后者与针灸临床有着密切的关系,能够为临床选穴提供有力的实验依据,也是近年来穴位特异性研     

Increased regional homogeneity in internet addiction disorder: a resting state functional magnetic resonance imaging study

Background Internet addition disorder （lAD） is currently becoming a serious mental health problem among Chinese adolescents. The pathogenesis of lAD, however, remains unclear. The purpose of this study applied regional homogeneity （ReHo） method to analyze encephalic functional characteristic of lAD college students under resting state. Methods Functional magnetic resonanc image （fMRI） was performed in 19 lAD college students and 19 controls under resting state. ReHo method was used to analyze the differences between the average ReHo in two groups. Results The following increased ReHo brain regions were found in lAD group compared with control group： cerebellum, brainstem, right cingulate gyrus, bilateral parahippocampus, right frontal lobe （rectal gyrus, inferior frontal gyrus and middle frontal gyrus）, left superior frontal gyrus, left precuneus, right postcentral gyrus, right middle occipital gyrus, right inferior temporal gyrus, left superior temporal gyrus and middle temporal gyrus. The decreased ReHo brain regions were not found in the lAD group compared with the control group. Conclusions There are abnormalities in regional homogeneity in lAD college students compared with the controls and enhancement of synchronization in most encephalic regions can be found. The results reflect the functional change of brain in lAD college students. The connections between the enhancement of synchronization among cerebellum, brainstem, limbic lobe, frontal lobe and apical lobe may be relative to reward pathways.     

fMRI在脑肿瘤诊断中的应用价值初探

目的：探讨fMRI在脑肿瘤诊断、鉴别诊断及肿瘤浸润边界划定中的价值。方法：脑肿瘤35例,均行MR平扫、增强、DWI及MRS。在肿瘤强化区、瘤周区、正常参照区,DWI测量各区域信号值,计算相对表观扩散系数（rADC）值;^1H—MRS行MVS采集NAA、Cho、Cr、Lac等波峰,计算不同区域各代谢物比值均值,比较统计学差异。结果：DWI示肿瘤强化区rADC值在脑膜瘤与星形细胞瘤、转移瘤间有显著性差异（P〈0．05）;瘤周区rADC值在星形细胞瘤与脑膜瘤、转移瘤间有统计学差异（P〈0．05）。多体素^1H—MRS示肿瘤强化区各代谢物比值均值与正常参照区比较有显著性差异（P〈0．05）;瘤周区,星形细胞瘤、转移瘤和脑膜瘤间多组代谢物比值具统计学差异（P〈0．05）。结论：fMRI与常规MRI相结合有助于脑肿瘤的鉴别诊断以及确定病灶浸润范围。     

Functional magnetic resonance imaging study of writer’s cramp

Background Writer＇s cramp is a type of task specific idiopathic focal dystonia and has an incompletely understood pathophysiology. The present study utilized functional magnetic resonance imaging （fMRI） to investigate what type of brain activity correlates with writer＇s cramp and its physiological mechanism.Methods Ten patients with writer＇s cramp were age and gender matched with ten nealthy control suojects in a block design. Subjectswere scanned by fMRI while performing three consecutive, visually instructive, tasks with MR Vision 2000： （1） suppositional writing, （2） writing with finger and （3） writing with a pencil. Data was analysed using AFNI software for groups of patients and controls.Results The patients with writer＇s cramp showed significant activations of contralateral basal ganglion （especially the putamen）, motor cortex （primary sensorimotor cortex, supplementary motor cortex, premotor cortex） and ipsilateral cerebellar hemisphere in writing with a pencil compared with controls; whereas there was no obvious difference between patients and controls during writing with finger. Furthermore, these differences exist in the stibtractive activated maps for ＂writing with a pencil＂ minus ＂writing with finger＂ of patients, when the activation of subcortical area and insula in controls disappeared.Conclusions Abnormal activations of contralateral basal ganglion, motor cortex and ipsilateral cerebellar hemisphere of the patients with writer＇s cramp suggest dysfunction of basal ganglion and subcortical-cortical loop might play a pathophysiological role in writer＇s cramp.     

大学生网络成瘾现状研究

大学生网络成瘾是近年来国内外的热门研究话题,本文对网络成瘾的定义?概念?诊断标准?形成机制以及治疗手段作了综述;分析对比了各主流学说的观点,并提出大学生网络成瘾的新特点?     

Functional magnetic resonance imaging and immunohisto-

Background The hypothalamus plays a central role in the regulation of metabolism by sensing metabolic demands and releasing regulatory neurotransmitters. This study investigated the response of the hypothalamus to glucose ingestion in rats by blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) and immunohistochemical techniques to determine the role of the hypothalamus in glycoregulation during disturbances in carbohydrate metabolism. Methods The signal intensity of the hypothalamus was monitored by fMRI for 60 minutes after oral glucose intake in 48 healthy rats (age 14 months), which included 24 normal weight rats (weighing (365±76.5) g) and 24 overweight rats (weighing (714±83.5) g). Then, 12 rats (6 normal, 6 overweight) underwent a repeat fMRI scan after consuming an equivalent amount of water without glucose on a separate day. The procedure for fMRI with water intake was the same as for glucose ingestion. fMRI data was processed using time cluster analysis and intensity averaging method. After fMRI, the expression of neuropeptide Y (NPY) and 5-hydroxytryptamine (5-HT) in the hypothalamus of all rats was determined by immunohistochemistry. Positive cells for NPY or 5-HT were counted. Results There was a transient, but significant, decrease in fMRI signal intensity in all rats (mean (3.12±0.78)%) in the hypothalamus within 19.5–25.5 minutes of oral glucose ingestion. In overweight rats, the decrease in signal intensity in response to the glucose ingestion was more markedly attenuated than that observed in normal weight rats ((2.2±1.5)% vs (4.2±0.7)% inhibition, t=2.12, P<0.05). There was no significant response in the hypothalamus after oral water ingestion. The percentage of NPY positive cells in obese rats were slightly lower than those in control group (21% vs 23%, t=0.71, P>0.05); but there was no significant difference between the two groups; the percentage of 5-HT positive cells in obese rats were significantly lower than those in the control group (22% vs 31%, t=3.25, P<0.01).Conclusions There is a transient, but significant, decrease in BOLD signal intensity in the hypothalamus following glucose ingestion, which is similar to that observed in humans. The response of the hypothalamus to glucose ingestion was different in overweight and normal weight rats. The percentage of NPY positive cells in obese rats were lower than those in the control group, although this difference was not statistically significant. The percentage of 5-HT positive cells in obese rats was significantly lower than those in the control group.     

低年级大学生网络成瘾及成瘾倾向状况调查

目的:调查低年级大学生网络成瘾及成瘾倾向,了解其心理健康状况及所采取的应对方式,为大学生网络成瘾的早期干预提供依据。方法:分层抽取安徽某大学一、二年级大学生190名,使用《网络成瘾诊断量表》、《SCL-90症状自评量表》和《特质应对方式问卷》进行自填式问卷调查。结果:调查对象网络成瘾检出率为5.3%,其中男生8.1%,女生3.9%,差异无统计学意义(P0.05);二年级为8.9%,高于一年级1.1%(P0.05);网络成瘾倾向检出率为16.8%,其中男生19.4%,女生15.6%,差异无统计学意义(P0.05);二年级为19.8%,高于一年级13.5%(P0.05)。网络成瘾组及倾向组与正常组比较,SCL-90总分及各因子分均高于正常组(P0.01);在应对方式上,网络成瘾组与正常组在消极应对上差异有统计学意义(P0.01),积极应对上差异无统计学意义(P0.05)。结论:低年级大学生网络成瘾及倾向者心理健康水平较低,且倾向于使用消极的应对方式。     

原发性失眠症功能磁共振成像研究进展

原发性失眠症（PI）是一种常见的睡眠障碍,会影响人的认知、情绪调节等功能。多项研究表明PI涉及广泛的脑区异常。近年来,功能磁共振成像技术结合不同的分析方法被广泛应用于PI的研究,它可以客观、间接地分析大脑功能活动的改变,有助于阐明PI的神经病理学机制,并为疾病的早期诊断提供可靠的客观依据。本文综述了近年来任务态功能磁共振成像、静息态功能磁共振成像等技术和功能连接分析方法在PI中的应用。     

军校医学生网络成瘾特点及其与情绪调节方式的关系

目的 研究军校医学生网络成瘾特点及其与情绪调节方式的关系.方法 利用分层整群抽样抽取400名军校医学生为被试,用中文网络成瘾量表(Chinese internet addiction scale,CIAS-R)和情绪调节问卷(ERQ-Huang&Guo)进行调查,进行组间比较与相关分析.结果 ①网络成瘾各因子得分和总分未发现显著的性别、专业和子女结构差异.②强迫症状、耐受症状、时间管理问题、人际和健康问题以及网络成瘾总分存在显著的年级差异(P ＜0.05,P＜0.01),三年级量表得分均显著低于一、二年级(P ＜0.05,P ＜0.01),一年级强迫症状因子得分显著低于二年级(P＜0.01).③网瘾量表总分及各症状分与情绪抑制调节和情绪宣泄调节均存在显著相关(P＜0.05,P＜0.01).④不同程度情绪调节组之间在网瘾量表各因子分上差异有统计学意义(P＜0.01),高分组网瘾量表各症状因子分均高于低分组,且情绪抑制调节高分组与低分组差异更显著.结论 高频率使用宣泄或抑制情绪调节方式可能更加容易导致网络成瘾.     

网络成瘾大学生的感觉寻求水平及神经诱发电位特征

目的：比较网络成瘾大学生的感觉寻求差异、神经诱发电位特征,为探讨网络成瘾机制提供基础。方法：采用Young氏网络成瘾诊断问卷、感觉寻求问卷作为研究工具,对1 784名在校大学生进行问卷调查;选择网络成瘾与非成瘾志愿者各10名进行以90 dB的短纯音作为刺激检测其长潜伏期听觉诱发电位。结果：网络成瘾大学生占总人群的7％,男性网络成瘾者显著多于女性（P<0.05）,年级间网络成瘾检出率差异无显著性（P>0.05）网络成瘾大学生在感觉寻求的去抑制因子和总分上高于非成瘾者（P<0.05）;网络成瘾者的N1波幅在Fz部位高于非成瘾者（P<0.05）,网络成瘾与感觉寻求之间存在正相关关系（r＝0.340,P<0.01）。结论：网络成瘾者与非成瘾者的感觉寻求水平与神经诱发电位有关联,高校应该关注高感觉寻求者的精神生活,避免网络成瘾。     

抑郁症患者局部脑功能静息态磁共振成像研究

目的通过静息态功能磁共振成像(rsfMRI)技术和局部一致性(regional homogeneity,ReHo)分析方法,探讨抑郁症患者基础状态下自发神经活动特点及脑功能变化。方法选取年龄、性别和文化程度匹配的10例抑郁症患者和13例正常对照组被试,采用DPARSF软件进行静息态功能数据的预处理,计算两组被试全脑的ReHo值。采用SPM5软件对两组全脑ReHo值进行基于体素的组间比较,考察抑郁症患者和正常对照组静息状态脑功能差异。结果与正常对照组相比,抑郁症患者存在涉及顶叶、颞叶和边缘叶等多个认知控制和情绪加工相关脑区的自发神经活动异常,其中右侧丘脑、左侧下顶叶、缘上回、右侧小脑、右侧顶内沟和右侧齿状回表现出功能一致性增强(P<0.01),中脑和右侧后扣带回功能一致性减弱(P<0.01)。结论抑郁症患者存在多个脑区的静息态功能一致性异常,这些区域多与认知控制和情绪加工有关。