磁共振波谱分析对躯体形式疼痛障碍的功能定位

THE STUDY OF THE FUNCTIONAL LOCATION OF PERSISTENT SOMATIC PAIN DISORDER BY USING MAGNETIC RESONANCE SPECTROSCOPY

摘要:

目的 :用磁共振波谱分析的方法 ,研究躯体形式疼痛障碍的脑生化物质代谢在不同脑区域内的变化 ,以证明丘脑是否可以作为躯体形式疼痛障碍的定位区域 ;以及研究躯体形式疼痛障碍与抑郁症和正常人之间 ,是否存在不同脑区域间的生化代谢的不同。方法 :对 6名躯体形式疼痛障碍者 ,11名抑郁症患者 ,8名正常人用磁共振波谱分析的单体素定位扫描的方法 ,扫描各组对象的左右丘脑 ,在部位上对比以额叶 ,获得NAA(天门冬氨酸 ) ,Cho(胆碱 ) ,Cr(肌酸 )的波峰下面积 (Inte gral) ,取相对值NAA/Cr和Cho/Cr作为分析指标 ,进行不同组间 ,不同部位间的对比分析。结果 :躯体形式疼痛障碍组NAA/Cr值在优势半球丘脑上明显低于正常对照组 (P <0 .0 5 ) ;抑郁症组在非优势半球额叶的Cho/Cr值明显高于正常对照组 (P <0 .0 5 ) ;在躯体形式疼痛障碍组中优势半球丘脑的Cho/Cr明显低于非优势半球丘脑 (P <0 .0 5 ) ,但这种差异的大小在三组间没有区别 (P >0 .0 5 )。结论 :躯体形式疼痛障碍者的优势半球丘脑存在着神经元的受损 ,故优势半球丘脑可能成为躯体形式疼痛障碍的功能定位区域。

Abstract:

Objective: By using Magnetic Resonance Spectroscopy (MRS), the variations of substance metabolism in different encephalic regions of patients with persistent somatoform pain disorder (PSPD) or depression were observed, in order to prove whether the thalamus can be the encephalic location of PSPD. Methods: Using single voxel of MRS,we scanne the brains of 6 patients with PSPD ,11 with depression and 8 normal persons to get Integral of NAA,Cho and Cr,in thalamus and frontal lobes. Result: NAA/Cr of the thalamus of the dominant hemisphere in PSPD group was significantly lower than that in normal control group( P <0.05);Cho/Cr of the frontal lobe of non-dominant hemisphere in depression group was obviously higher than that in normal control group( P <0.05);Cho/Cr of the dominant thalamus in PSPD group was obviously lower than that in non-dominant side( P <0.05). Conclusion: The thalamus of dominant hemisphere might be the encephalic location of PSPD.