ѨλͼRenTiXueWei.comרעҽѨλƷ ߼ | TAGǩ | վͼ | Ϊҳ | ղ
Ρ| ڿ | | | | | | | θ | س | | | ε | | | Ƥ | | Ѫ | |
ǰλãҳ>ڿ>񾭼>ƫͷʹ>

ƫͷʹѨλҽƷо

ʱ:2018-09-13 11:42 Դ:RenTiXueWei.com :Ѩλͼ

ƫͷʹfMRIоչ

ƫͷʹһȫΧھнϸ߷ʵ ϵͳ 1 йߴ 9 3% 2 ͬʱҲһ Ӱ컼ᾭø Լ 3 ٴֳͷ˫ ಫʹ⣬ ƫͷʹʹʱ ͬʱ жŻ¡ ηηٴ֡ƫͷʹ ӵķ뷢ڣ ʹƫͷʹߵ һѶȣ ³ֽϸߵ 4 ԴŹ( functional magnetic reso- nance imaging fMRI) ṩӿɿ ۼٴ֤ݣ ֢״ƫͷ ʹ߾ڽȺ߸ ӾƤ߷Ӧ 5 һ֧Ƥ Ƶѧ˵ʹ( Ƶʡ ʱ䡢 ̶) Ի 6 Թӽͣ һḻʹ о 7 緶Χڵõ㷺Ӧ 8 ƫͷʹѳΪֵƼЧ ȫ ҩ ﲻӦƷ 9 fMRI ȫ޷Σƣ ʹڽ еõ϶Ӧã Ѩλԡ Ѩλ Ч֤ȷоõ͹۵Ŀѧݡ

һ

ͨ 10 PubMed MEDLINE Cochrane й֪( CNKI) άյݿ⣬ õƫ ͷʹ fMRI о 14 ƪ Ӣ 10 ƪ 4 ƪų 6 ƪ( 3 ƪ 1 ƪ о1 ƪ 1 ƪ) 8 ƪס

о뷽

( һ) ƫͷʹ

ҪΪϹͷʹķڶ ( international classification of headache disorders 2 nd edition ICHD- II) ϵƫͷʹ 10- 17 6 ƪΪ׼ƫͷʹ( migraine without auraMwoA) 10- 15 2 ƪ 16 17 Ϸ ׼ƫͷʹ δȷ͡Ƴ̷ 棬 5 ƪ 10- 11 13- 17 ƳΪ 4 ܣ 1 ƪ 16 ׼ Ϊ8 ܣ 1 ƪ 17 ƳΪ 5 ; 1 ƪ 12 ׹۲ ̵ļЧӦ3 ƪ 10- 11 13 ׵Ķ齫߷Ϊ ͬ 3 Ѩλ鴦 VA( verum acupunc- ture) 飬 ΪȽϲͬѨλ鴦ṩ

( ) ѡ 8 ƪУ 7 ƪ 10- 16 ׾ͷʹĽ ȺΪ( healthy controlHC) 1 ƪ 17 õͷʹ顣 3 ƪ 10- 11 13 о HC ⣬ Ҳδĵȴ( waiting- list WT) ͼ( sham acupunctureSA)

( ) ɨʱ 7 оδԤǰƳ̽ 2 fMRI ɨ 10- 11 13- 17 1 ƪо۲ ЧӦ ֱڻǰ 30 min ɨǰԤ ̣ 8 min Ϣ̬ɨ裬 10 s ƽƽк 1 min 8 min άʱ 9 min 10 s ɨ 12 ( magnetic resonance spetroscopy MRS) оĵɨʱΪ 4 min 25 s ɨʱΪ 8 min 26 s

( ) fMRI оĿݷѡ ڲͬ fMRI ݷȱ㣬 ͨ оIJصѡӦķϢ̬ ( resting stateRS) fMRI ݷҪԹ Ϸ;ֲԻ: ǰй ( functional connectivityFC) ɷַ ( independent component analysisICA) ; оֲ һ( regional homogeneityReHo) Ƶ ( amplitude of low frequency fluctuationALFF)

1 ԹϷϢ̬( resting state functional connectivityrs- fc) ķõ ѡӵ( seed- based analysisSBA) Ϊ ķȻ SBA rs- fc ķѡ ӽУ ѡͬӵͬ ӽ ˲ܸõķӳԹ rs- fc 18 ICA 18 ԽϺõĴӶ Ѱδ֪ ڲʱ£ Ǹ˹źԴϣ ȱ ɷ޷ȷ ɷȱ塣 ɵʹã ҲԽʹ ICA SBA ֲֲ㡣Li 11 2017 о У Ȳ ICA ʴȡþϢ̬ 磬 ҴӽȺȡģ磬 ֮Ҷ( right frontoparietal networkrFPN) ߵĿռغϴ rFPN Ҳø rFPN Ϊģ( generalized linear model GLM) ĸռ ͨԸʱн ȡÿ rFPN ֮ľϢ̬ ǿȺ ڲ졣 ICA ͻШǰҶΪӵ㣬 û SPM ĵڻƽнһ rs- fc ۲졣

ͳƲӳ( statistical parametric mappingSPM) һֽ GLM ͸˹۵ķLi 13 2015 онøԵˮΧ ( ventrolateral periaqueductal grayvlPAG) Ϊ 㣬 ԵˮΧ͵ҵӵΪ ա

Zhang 14 ICA ͨ GIFT ԹõѵľϢ̬ goodness- of- fit ֵ rs- fc Ƚϲ SPM Li 15 ͬ ICA ƫͷʹߵ RFPN й۲죬 ǰ߽Ļ趨ɢ( diffusion tensor imagingDTI) о 3 Ȥ( region of interestROI) ֱΪǰԹ rs- fc Ͳλ rs- fc λǰأ Ϊ Ԫ״̬ṩݡΰ 12 Զܱǩѧ( anatomical automatic labeling AAL) ģȡ 90 ʱߣ ÿߵ AAL ֮ Pearson ؼ ˴˵ĹӶȻþ ȡ¾ ͬʱûͳ( network- based statistic NBS) ڱȽϡ

2 ֲԻReHo ǻڿϵ¶г ϵ( kendall's coefficient of concordanceKCC) һſ֮ʱеı仯 19 ÿ ؾһ ReHo ֵ ӳ۲Χ Ѫˮƽ( blood oxygen level dependent BOLD) źʱͬԡҪ۲ֲ źšZhao 16 Ӧ ReHo ͨ ʱмΧ 26 ڽ KCC ֵ; Ȼ ͨ KCC ֵ KCC ͼ ͨͬȺıȽϣ Ƶľһ ԡ ALFF ҲǾֲԻķ Ҫͨ ÿ ALFF ĴСӳԪǿ 19 Li 10 2017 귢ов ALFF ۲ƫͷʹ߾Ϣ̬µԷ ȽѨѨƫͷ ʹߵԹܵڻơ

( ) Ѩλѡ

8 ƪвõѨλľ ء ˿ ʹȵ; ķء Ȫ ; ĺϹȡ ƫ; ; ̫塢 м; ̫̫; ٻ; ĴԼѨ̫ȡ

Zhang 14 Li 15 Ѩλ漰 ͬѨ ξıᆳѨ λԶ Ѩ鷽ʽLi 10- 11 13 1 ͬѨ ȡȪ 桢 أ ȪΪ ºѨ ΪԭѨ ΪѨ; 2 ȡѨҲͬѨ ȡϥء ᡢ 磬 3 ѨλضѨ 3 ͬѨ ȡѨ ƫ ΪθºѨ ΪθԭѨ ƫΪ ѨZhao 16 ȡͷѨ ( أ ά) Ѩ( أ Ѩ ͨά) ԭѨ( ) ºѨ ( Ȫ) Ѩλͷ֫ԶѨ ͬѨΪ; ȡs ꡢ ̫ ף ̫ ֡ ѭضѨ ε 17 ȡͷٻᡢ ء ֫ ξѨм( ξѨ) 鷽Զ͸ ᆳѨΪ( 1)

ѨλѨλƫͷʹĻо ȡһɹ ١ fMRI ԲȫӳʵЧӦ Ѩλ о⡣

о

3 ƪõٴƷͬ õ fMRI ͬ 10 11 13 ALFF ʾ δǰ MwoA ںԵ ״( Ǻ/β״) ALFF ֵߣ ͷ ( rostral ventromedial medulla RVM) /񾭾( trigeminocervical complex TCC) ALFF ֵ 10 ƺ MwoA RVM/ TCC ALFF ֵڽ Ⱥоʾʹͨ·̬ʧ Ӱ MwoA 񾭲չ Ч ƿʹͨ·̬ʧõͬ ʱ ICA ʾ HC ȣ MwoA ǰ Ҷ FPN( frontoparietal network FPN) ˫ ШǰҶ֮ rs- fc 11 rs- fc ͵õƣ طִ rs- fc ƿɻ ͷʹij̶ȡһШǰҶΪӵ SBA ҲҲШǰҶҲ FPN( rACC/MPFC ״壬 /ص) ֮ rs- fc ʾƽ оʾ MwoA һӦ ͷʹ̼Ӧڻƣ һֻӦʹ ʱĻرܻơЧʹûƵõǿ ʹƫͷʹ߶˺Դ̼Ӧõ ԴﵽƫͷʹЧһ SBA оԸ ԵˮΧ( ventrolateral periaquaductal grayvlPAG) Ϊӵ㣬 ʾ HC Ƚϣ MwoA vlPAG ǰ۴Ƥ ( anterior cingulate cortexACC) ֮ rs- fc 13 rs- fc ֵ Խͣ ʹ̶Խǿ rs- fc õ PAG ƫͷʹʹڻ ( descending pain modulatory system DPMS) Ҫ ֮һ 20 оƫͷʹ DPMS ǰҶƤ( prefrontal cortexPFC) ACC Ե ڲԵȺ PAG ֮ rs- fc 21 ACC/mPFC зḻİƬ壬 ƬԴʹ 22 ˣ Чǿ ƫͷʹ vlPAG ACC/ mPFC ֮쳣 ͵ rs- fc ״̬ ʹ MwoA ܵ𺦵 DPMS ״̬

ΰ 12 оʾ ( HC ) ƫͷʹຣԻء ˫ غǻ֮Ĺߡʾ ʹͨ· оƤʹ ȣ ʹĸоڡ Zhang 14 ICA оʾ ǰ ϣ MwoA ͵ rs- fc õ FPN( ˫ϻء ڲغͶСҶ) DMN ( ШǰҶ ۴ƤͿ۴) ϻ( superior temporal gyrus STG) ( middle temporal gyrusMTG) ԵлصȡFPN 23 Ϊ Դʹ 24 оҪáDMN 25 ϰ Ϊ ֪ עIJҪӰ졣 DMN 뷴ƫͷʹй 26 ˣ ΪƿɵԹ rs- fc Ԥ MwoA ûơ

Li 15 ICA MwoA ǰ ǰء Եϻء rFPN ֮ 併͵ rs- fc õ طʾ rs- fc Խ ߣ VAS ֵԽ͡һ DTI о֣ 3 ROI 3 άλû ϡЩάҺҵĺ֫ Է ·֮һԵǰͺֱо 27- 28 Zhao 16 ReHo ʾ ԡ ACC STG ͸˶( supplementary motor area SMA) ReHo ֵ϶; ں л ( middle frontal gyrusMFG) MTG ReHo ֵ ڶ顣Ե ReHo ֵ ط VAS ʹֵʸء۴Ƥ ( posterior cingulate cortexPCC) ШǰҶ з ReHo ֵı䣬 DMN ҪɡDMN ǻߴ “Ϣ” Ȳ Χ/¼עʱڵԹ硣 ʹעʱ DMN ʧ; ߶ʹ Ĺע( ڸš ˼תƻע ) ʱ DMN ڣ DMN Ϊ뻼߶ ʹעй 29 ƫͷʹʱ ʹ/Ƥ֮ĹܵӰ 30 ע֮Ĺӷ 31 ʾƫͷʹӣɵ֪ ܵĽһ𺦡 ACC 鲻ͬѨλ е ReHo ֵ ˣ Ϊ ƶƫͷʹĹͬ оʾ 32 Ե Ժ ACC ʹļ 䣬 Ӱ컼߶ʹĸܾˣ Ϊ ͨƫͷʹڣ ҵڻ ľ̬ ﵽǿֹʹӳЧ Ŀġ

ε 17 MRS оͨ۲ҲԺͿ ǰ N- Ŷ( N- acetylas- partateNAA) / ( creatineCr)  ( choline Cho) /Cr ֵ ʾӰƫͷʹ Ե NAA/Cr ֵо NAA ĺܷӳ ԪܶȺ͹ 33 NAA ½ɴ Ԫ˼Ӧܵȱʧ ӳϵͳķ 34 Cr ʹڲ״̬Ҳȶ״ ̬ 35 оʾ ƫͷʹߵ NAA Cho Աֵ½ 33 Ӧλ NAA/ Cr ˮƽߣ ʾԪϸֳԪл ĻԾˣ ɸƫͷʹҲԵ Ԫл ӶӰʹﵽʹЧ

ġ չ

ƫͷʹԤִҽѧ⡣ƫͷ ʹߵʹоϳУ “ ̬ʧ” fMRI DzƫͷʹķҪ о;Ϣ̬ fMRI ӹ۲ʾƫͷ ʹڷ뷢۾۾Ƶ 繦쳣 ʾʹڻƵ ʧ ƫͷʹʹIJ鷢չ ӳڵͷʹɶƫͷʹԹܵӰ졣

fMRI ƣ Ҫ ֲһַIJ㣬 в ICA SBA ϣ о ԡ ЧӦȱ 36 ʾϷ ( SBA ICA ) ֲ( ICA ALFF) Ӧõ ơ

ƫͷʹƵĸԡ fMRI ľԡ оʵԣ ƫͷ ʹ fMRI о ҪиϽо ԡ коĿĵĿѧ衢 淶 fMRI Ӱزòͬķ ֤

ͳַ ѨλԺѨλ ȷĻоѧо 㡣ͨ fMRI ѨλЧӦص㣬 ѨԪѨ 37 ̫ Ѩ 38 ʹӦȡfMRI Ѩλ ԣ ѨλõӦо һṩ ٴרҵָо˼·

Դл־ ߣ p Ὠ
Tagǩ ƫͷʹ(13)
Ѩλ
վϢο ΪϼҽƵ
Ѩλͼ  ICP09003292 湫 43042602000101