【摘要】：目的:探索前庭性偏頭痛(VM)患者的異常神經(jīng)通路,并定位其功能區(qū),以推斷其可能的發(fā)病機(jī)制。方法:對(duì)VM組(20例)、無(wú)先兆的偏頭痛(MwoA)組(20例)和健康對(duì)照組(20例)分別進(jìn)行冷水灌耳試驗(yàn),選擇刺激時(shí)以及刺激間歇期的全腦血氧飽和度依賴的功能核磁共振成像(BOLD fMRI),獲取VM組、MwoA組及健康對(duì)照組的激活區(qū),進(jìn)行組間對(duì)比。結(jié)果:所有試驗(yàn)對(duì)象冷水灌耳試驗(yàn)后,多處皮層及皮層下區(qū)域激活,頂葉、顳葉、島葉皮質(zhì)、扣帶回、丘腦、尾狀核區(qū)、視輻射、楔前葉均觀察到BOLD信號(hào)明顯改變。對(duì)比發(fā)現(xiàn)VM患者的丘腦背內(nèi)外側(cè)核區(qū)正激活,枕顳內(nèi)側(cè)回皮質(zhì)負(fù)激活(P0.05)。結(jié)論:fMRI能較客觀清晰地反應(yīng)腦部各功能區(qū)活動(dòng)情況;VM患者發(fā)病機(jī)制為丘腦背內(nèi)外側(cè)區(qū)及枕顳內(nèi)側(cè)回皮質(zhì)異常激活,在前庭感覺(jué)通路傳遞過(guò)程中與痛覺(jué)通路產(chǎn)生交叉。
[Abstract]:Aim: to explore the abnormal neural pathways in patients with vestibular migraine (VM) and to locate their functional regions in order to infer the possible pathogenesis. Methods: cold water perfusion test was performed in VM group (20 cases), migraine without aura group (20 cases) and healthy control group (20 cases). Functional magnetic resonance imaging (bod fMRI) was used to obtain activation areas of MwoA group and healthy control group during stimulation and intermittent stimulation. Results: after cold water perfusion in all subjects, the activation of multiple cortical and subcortical regions, the changes of bod signal were observed in parietal lobe, temporal lobe, insular cortex, cingulate gyrus, thalamus, caudate nucleus, visual radiation and prewedge lobe. The positive activation of dorsal and lateral thalamic nucleus and negative activation of medial occipito-temporal cortex were found in VM patients (P0.05). Conclusion in VM patients, the abnormal activation of the medial and dorsal thalamic area and the medial occipito-temporal cortex is the mechanism of abnormal response to the activity of the functional regions of the brain by FMRI, which intersects the nociceptive pathway during the transmission of vestibular sensory pathway.
【作者單位】： 天津市環(huán)湖醫(yī)院耳鼻咽喉頭頸外科;
【分類號(hào)】：R747.2

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