神经根型颈椎病慢性颈肩痛患者脑默认网络研究

目的运用独立成分分析法(independent component analysis,ICA)探究神经根型颈椎病(cervical spondylotic radiculopathy,CSR)慢性颈肩痛患者脑默认网络(default mode network,DMN)功能连接的变化。材料与方法采用3.0 T MR对29名受试者进行颅脑常规扫描、高分辨率3D-T1结构像及静息态功能MRI扫描,扫描结束后收集每例患者视觉模拟评分(visual analogue score,VAS)数据。采用ICA分离及识别默认网络,组间对比分析两组DMN功能连接的改变,将有差异的脑区功能连接强度与VAS评分进行pearson相关性分析。结果神经根型颈椎病慢性颈肩痛患者丘脑、海马、基底核、左侧颞中回及楔前叶的功能连接强度减低,右侧颞上回功能连接增强。海马的功能连接强度与VAS得分存在负相关(r=-0.546,P=0.043)。结论 CSR慢性颈肩痛患者的脑DMN功能连接强度发生变化,可能与患者的认知痛觉加工、情绪处理和记忆功能变化相关。

A research of the default mode network in patients with chronic neck and shoulder pain of cervical spondylotic radiculopathy

Objective: To explore the changes of DMN functional connections in cervical spondylotic radiculopathy(CSR) patients with chronic neck and shoulder pain by independent component analysis(ICA). Materials and Methods: Twenty-nine subjects were scanned with conventional magnetic resonance, high resolution 3 D-T1 structural imaging and resting state functional magnetic resonance(rs-fMRI) using 3.0 T MR. VAS was performed at the end of the scan. ICA was used to separate and extract the DMN. The changes of the DMN functional connections between the two groups were compared and analyzed. Pearson correlation analysis was made between the functional connections strength of different brain regions and VAS score. Results: Compared with the normal group, the functional connections of thalamus, hippocampus, basal nucleus, left middle temporal gyrus and anterior cuneiform lobe decreased, and the functional connections of right superior temporal gyrus increased in patients. There was a negative correlation between hippocampal functional connections and VAS score(r=-0.546, P=0.043). Conclusions: The changes of functional connections of DMN in patients with chronic pain of CSR may be related to the changes of cognitive pain processing, emotional processing and memory function in patients with chronic pain of CSR.