本文選題：原發(fā)性月經痛 + 彌散張量成像�。� 參考：《西安電子科技大學》2014年碩士論文

【摘要】：原發(fā)性月經痛是一種子宮的經期痙攣引起的疼痛,廣泛存在于生育年齡的女性的婦科疾病。流行病學研究表明40%到84.8%的處于青少年的女性有過原發(fā)性月經痛的經歷,其中大約有15%的人曾經有過劇烈疼痛的感覺。原發(fā)性月經痛對女性的影響已經產生了巨大的社會經濟損失。為了找到有效的治療原發(fā)性月經痛的方法,需要對這種疾病的病理機制進行進一步研究。近年來,神經成像技術已經被廣泛地應用于研究慢性痛患者的大腦結構和功能異常。目前,有很多有關慢性痛的研究都報道發(fā)現(xiàn)病人的大腦的功能、灰質、白質的變化。有的研究發(fā)現(xiàn)原發(fā)性月經痛患者的大腦功能和灰質的改變,但是月經痛患者的大腦白質到目前為止還沒有人進行探究。原發(fā)性月經痛作為與慢性痛相似的疼痛類疾病,應該也會引起白質的改變。同時,彌散張量成像技術為我們提供了估測活體狀態(tài)下白質的走向和連接度的可能。因此,本論文主要利用彌散張量成像技術研究月經痛患者的大腦白質結構的變化。首先,我們利用基于白質骨架的空間統(tǒng)計分析方法探究原發(fā)性月經痛患者白質與正常被試的白質的組間差異。結果發(fā)現(xiàn),與正常人相比原發(fā)性月經痛患者病在許多白質區(qū)域上有較高的分數(shù)各向異性值以及較低的平均彌散率和徑向彌散率,但是正常被試在白質區(qū)域沒有顯示出有較高的分數(shù)各向異性值或者較低的平均彌散率值和徑向彌散率。另外,我們還發(fā)現(xiàn)有些白質區(qū)域病人的分數(shù)各向異性的升高伴隨著平均彌散率和徑向彌散率的降低。其次,我們使用多變量模式分析的方法對這些顯著差異的區(qū)域和測量值進行篩選以得到對分析原發(fā)性月經痛的神經生理機制最有用的區(qū)域和測量值。我們將被試在各個測量值上顯著差異的區(qū)域的對應的各個測量值的平均值提取出來。將這些提取得到的測量值的平均值作為特征量放入線性支持向量機中進行訓練,并計算每個特征量的權值。訓練完后用另外一組被試測試訓練得到的支持向量機的性能。測試完后去除權值最低的特征量,然后在重復訓練和測試的過程,直到滿足終止條件為止。這樣,我們得到測試結果最好的白質區(qū)域:放射冠、胼胝體、扣帶、上縱束、丘腦,這些區(qū)域已經被其他研究證實與疼痛和感覺有關的。總之,這些研究結果表明原發(fā)性月經痛患者的白質有異常的變化,并且這些異常區(qū)域主要在疼痛感知的通路中。
[Abstract]:Primary menstrual pain is a pain caused by menstrual spasms of the uterus. It is a gynecological disease in women of reproductive age.Epidemiological studies show that between 40 percent and 84.8 percent of teenage women have experienced primary menstrual pain, and about 15 percent of them have experienced severe pain.The impact of primary menstrual pain on women has caused enormous socio-economic losses.In order to find an effective treatment for primary menstrual pain, the pathological mechanism of the disease needs to be further studied.In recent years, neuroimaging technology has been widely used to study the brain structure and function abnormalities in patients with chronic pain.Currently, many studies on chronic pain have reported changes in brain function, gray matter, and white matter in patients.Some studies have found changes in brain function and gray matter in patients with primary menstrual pain, but no one has yet explored the white matter of the brain in patients with menstrual pain.Primary menstrual pain, as a painful disease similar to chronic pain, should also cause changes in the white matter.At the same time, dispersion Zhang Liang imaging provides us with the possibility of estimating the direction and connectivity of white matter in vivo.Therefore, diffusion Zhang Liang imaging technique was used to study the changes of white matter structure in patients with menstrual pain.First, we used the spatial statistical analysis method based on white matter skeleton to explore the difference between white matter and normal subjects in patients with primary menstrual pain.The results showed that patients with primary menstrual pain had higher fractional anisotropy and lower mean and radial dispersion rates in many white matter areas than those in normal subjects.But normal subjects did not show higher fractional anisotropy or lower average dispersion rate and radial dispersion rate in the white matter region.In addition, we found that the increase of fractional anisotropy in some white matter areas was accompanied by a decrease in the average diffusion rate and radial dispersion rate.Secondly, we used multivariate model analysis to screen the regions and measurements of these significant differences to obtain the most useful areas and measurements for the analysis of the neurophysiological mechanisms of primary menstrual pain.We extracted the mean values of the corresponding measurements in the regions where the measured values were significantly different.The average value of these measured values is trained in the linear support vector machine (LSVM) as a feature, and the weights of each feature are calculated.After the training, another group of participants tested the performance of the trained support vector machine.After testing, the least weight feature is removed, and then the training and testing process is repeated until the termination condition is satisfied.Thus we obtained the best areas of white matter: corona callosum cingulate superior longitudinal tract thalamus which have been confirmed to be related to pain and sensation by other studies.All in all, these findings suggest abnormal changes in white matter in patients with primary menstrual pain, and these abnormal areas are mainly in pain perception pathways.
【學位授予單位】：西安電子科技大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R445.2;R711.51

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本文編號：1755547