肝气郁结证患者汉字词组听觉工作记忆功能磁共振成像研究

目的利用功能磁共振成像(fMRI)对肝气郁结证患者听觉汉字词组工作记忆的脑功能改变进行研究,以期定位肝气郁结证在脑内的功能区以及是否有认知功能的改变,揭示该证的脑机制。方法16例肝气郁结证患者,其中男性5例,女性11例,年龄25～50岁,按年龄、性别配对选取16例正常志愿者。汉字词组听觉工作记忆任务作业采用block-design的1-back形式,扫描从静息开始,次序为静息—基线—静息—刺激—静息循环进行。扫描用Plilips1.5T磁共振机,数据处理采用基于MATLAB平台的SPM软件进行分析。结果正常组工作记忆激活脑区的数量和面积明显多于肝郁组,正常组激活脑区除左侧额下回(BA44/47,Broca运动语言区)外,其他脑区在肝郁组工作记忆降低时都受到抑制,并且肝郁组右侧顶叶也受到抑制。结论定位了肝气郁结证患者工作记忆改变的相关脑区,肝气郁结证可导致认知功能变化,为中医证型提供了可视的客观化证据。

Functional magnetic resonance imaging of brain auditory working memory of Chinese character phrases in patients with liver-qi stagnation syndrome

Objective To study the changes of brain auditory working memory of Chinese character phrases in patients with liver-qi stagnation syndrome by applying functional magnetic resonance imaging(fMRI),find the brain functional region of the liver-qi stagnation syndrome and the changes of cognitive function,and to reveal the cerebral mechanism of the syndrome.Methods The patients with liver-qi stagnation syndrome(n=16,male 5 and female 11)from 25 to 50 year-old and healthy postulants(n=16)according to the age and sex matching were chosen and scanned by magnetic resonance imaging.The task of brain auditory working memory function of Chinese character phrases was carried out in 1-bck of block-design.The scan was started from resting and the sequence was resting-baseline-resting-stimulating circularly by using magnetic resonance machine of Plilips1.5T.The data was processed with SPM software based on MATLAB platform.Results The number and area of activated brain regions of working memory in the healthy group were much more than those in the patient group.Besides the left inferior frontal gyrus(BA44/47,Broca motor speech region)of activated brain regions in the healthy group other brain regions and the right parietal lobe were inhibited in the patient group when the working memory reduced.Conclusion The brain regions were positioned related to the changes of working memory in the patients with liver-qi stagnation syndrome.The liver-qi stagnation syndrome can induce cognitive function changing,which provides the visual objectified evidence for TCM syndrome types.