本文選題：慢性偏頭痛　切入點：靜息態(tài)功能磁共振　出處：《河北醫(yī)科大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的:慢性偏頭痛(chronic migraine,CM)是一類發(fā)作頻繁、每月超過15天且病程超過3月的偏頭痛,發(fā)病時經常伴有顱神經、胃腸道及自主神經癥狀。以往諸多研究均證實偏頭痛患者存在腦部結構、功能等異常,但只有少部分研究對慢性偏頭痛進行了探討。靜息態(tài)功能磁共振(resting-state functional magnetic resonance imaging,rs-f MRI)反映的是靜息狀態(tài)下腦部的活動,這有助于理解慢性偏頭痛的發(fā)病原理。本研究運用局部一致性(regional homogeneity,ReHo)方法對慢性偏頭痛患者與健康受試者腦部自發(fā)活動的特征進行比較、分析。方法:本研究招募了性別、年齡、受教育程度均匹配的慢性偏頭痛患者和健康對照者各20名,運用靜息態(tài)功能磁共振局部一致性(regional homogeneity,ReHo)分析方法對兩組的腦功能狀況進行評價。在Matlab R2010a操作環(huán)境下,使用DPARSFA 2.2軟件進行數(shù)據(jù)預處理和后處理,使用REST軟件進行統(tǒng)計分析。首先對兩組分別進行單樣本t檢驗(P0.001,Alphasim corrected)以查看各組默認網(wǎng)絡情況,再進行雙樣本t檢驗(P0.05,Alphasim corrected)以比較組間差異,最后對病例組差異腦區(qū)的ReHo均值與病程、發(fā)病頻率、視覺模擬評分(visual analogue scale,VAS)等進行相關性分析。結果:病例組與健康對照組后扣帶回(posterior cingulate cortex,PCC)、內側前額葉皮質(medial prefrontal cortex,MPFC)、頂下小葉(inferior parietal lobe,IPL)、楔前葉的ReHo值與其它腦區(qū)相比顯著升高(P0.001,Alphasim corrected),提示默認網(wǎng)絡正常。與健康對照組相比,病例組前扣帶回(anterior cingulate cortex,ACC)的ReHo值顯著升高,左側基底神經節(jié)(basal ganglia,BG)、右側小腦的ReHo值顯著降低(P0.05,Alphasim corrected),升高及降低的t值最高點分別位于ACC和左側BG。且進一步研究尚未發(fā)現(xiàn)病例組差異腦區(qū)的ReHo均值與病程、發(fā)病頻率、VAS評分等有顯著相關性。結論:本研究運用ReHo方法分析慢性偏頭痛患者局部腦功能,發(fā)現(xiàn)ReHo值異常腦區(qū)和慢性偏頭痛患者靜息態(tài)下腦功能存在異常。該發(fā)現(xiàn)可能與痛覺調節(jié)系統(tǒng)的結構和功能受損有關，也為今后慢性偏頭疼的診斷和預防性治療帶來啟發(fā)。
[Abstract]:Objective: chronic migraine headache (CMM) is a kind of migraine with frequent onset, more than 15 days per month and the course of disease exceeding March, which is often accompanied by cranial nerve. Symptoms of gastrointestinal tract and autonomic nervous system. Previous studies have confirmed that migraine patients have abnormal brain structure and function. But only a few studies have studied chronic migraine. Resting state functional magnetic resonance imagingrs-f MRIs reflect brain activity in resting states. This is helpful to understand the pathogenesis of chronic migraine. In this study, the characteristics of spontaneous brain activity in patients with chronic migraine were compared with those in healthy subjects by using the regional homogenicity (ReHoA) method. Twenty patients with chronic migraine and 20 healthy controls with matched educational level were evaluated by rest functional magnetic resonance (fMRI) regional homogeneity (ReHoA) analysis. The brain function of the two groups was evaluated under the Matlab R2010a operating environment. DPARSFA 2.2 software was used for data preprocessing and post processing, and REST software was used for statistical analysis. First, two groups were tested with single sample t test (P0.001 ~ Alphasim corrected) to see the default network situation in each group. In order to compare the difference between the two groups, the mean value of ReHo, the course of disease and the frequency of the disease were compared between the two groups by the double t-test (P0.05Alphasim corrected). Results: the posterior cingulate cingulate cortexus of the posterior cingulate gyrus of the case group and the healthy control group were analyzed. Results: the ReHo value of the anterior cuneate lobe was significantly higher than that of the other brain regions. The medial prefrontal cortex was medial prefrontal cortextate MPFCs, and the inferior parietal lobules were inferior parietal lobegos. The value of ReHo in the anterior cuneate lobe was significantly higher than that in the other brain regions. The default network is normal, indicating that the default network is normal, compared with the healthy control group. The ReHo value of anterior cingulate cortexa of anterior cingulate gyrus in the case group was significantly higher than that in the control group. The ReHo values of the right cerebellum decreased significantly in the left basal ganglia and the right cerebellum, and the highest t values of the increased and decreased t values were located in the ACC and the left BGs.Furthermore, the mean value of ReHo and the course of disease in the different brain regions of the patients were not found. Conclusion: the ReHo method is used to analyze the regional brain function of patients with chronic migraine. It was found that the abnormal brain function in the patients with abnormal ReHo value and in the resting state of patients with chronic migraine may be related to the damage of the structure and function of the pain regulating system, and also provide inspiration for the diagnosis and prophylactic treatment of chronic migraine in the future.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R747.2

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本文編號：1633755