炎性肠病患者静息态功能磁共振成像低频振幅研究

Brain activities in patients with inflammatory bowel disease on resting-state functional MRI with amplitude of low-frequency fluctuation algorithm

目的炎性肠病患者内脏痛的发生可能与中枢神经系统对疼痛的异常处理有关,文中旨在采用低频振荡振幅(ALFF)算法静息态功能磁共振(rs-f MRI)研究炎性肠病患者脑功能改变的特点。方法收集2015年12月至2016年8月经南京医科大学第二附属医院消化科炎性肠病患者27例(病例组)和21例健康志愿者(对照组)。高分辨率结构像和rs-f MRI数据,通过ALFF分析方法对比2组患者脑功能活动的改变,观察病例组ALFF统计脑图与临床指标的相关性。结果与对照组比较,病例组内侧额回、右侧壳核、右侧岛叶、左中扣带回、双侧辅助运动区等区域ALFF值降低;额中回、左侧额上回、内侧前额叶等区域的ALFF值升高(P<0.05)。病例组顶下小叶、楔前叶、左中扣带回ALFF值与血沉呈负相关(r=-0.537、-0.588、-0.588,P<0.05);亦与病程、CRP呈负相关(P<0.05)。内侧额回ALFF值与CRP呈正相关(r=0.623,P=0.001)。结论炎性肠病患者存在多个脑区ALFF值的异常,主要位于与内脏疼痛、情绪的处理相关脑区。

Objective Visceral pain in patients with inflammatory bowel disease （IBD） may be associated with the abnormal processing of pain in the central nervous system. The aim of the study is to investigate the characteristic changes of brain functions in the IBD patients using resting-state functional magnetic resonance imaging （rs-fMRI） with the amplitude of low-frequency fluctuation （ALFF） algorithm. Methods This study included 27 cases of IBD treated in our hospital from December 2015 to August of 2016 and 21 healthy volunteers as normal controls. We recorded the high-resolution structure imaging and rs-fMRI data, compared the brain activities of the two groups patients by ALFF analysis, and evaluated the correlation of the ALFF values with the clinical parameters of the IBD patients. Results Compared with the normal control group, the IBD patients showed significantly decreased ALFF values in the medial frontal gyms, right putamen, right insula, left middle cingulate gyrus （ MCC ） , and bilateral supplementary motor region （P〈0.05） , increased ALFF values in the middle frontal gyrus , left superior frontal gyrus, and medial prefrontal lobe region （P〈0.05 ）. The ALFF values in the inferior parietal lobule, precuneus and MCC of the IBD patients were correlated negatively with the blood sedimentation rate （r=-0.537, -0.588, and-0.588, P〈0.05） , dis- ease course （ P〈 0.05 ） , and C-reactive protein （CRP） level （ P〈 0.05）, while that in the medial frontal gyrus positively with the CRP level （r=-0.623, P〈O.O01）. Conclusion IBD patients have ab- normal ALFF values in various brain regions, mainly in those involved in the processing of visceral pain and emotion.