右侧经典三叉神经痛患者中脑导水管周围灰质的功能连接研究

Study of brain functional connectivity changes of the periaqueductal gray in right classical trigeminal neuralgia patients

目的:采用静息态功能磁共振成像(rs-fMRI)观察右侧经典三叉神经痛(CTN)患者脑导水管周围灰质(PAG)与全脑的功能连接变化。方法:对21例右侧CTN患者(右侧CTN组)和35例健康志愿者(HC组)分别行rs-fMRI检查,选择PAG作为兴趣区,与全脑进行功能连接分析,得到两组间与PAG功能连接具有差异的脑区,并将右侧CTN组有差异的功能连接与患者的病程、疼痛评分进行相关性分析。结果:与HC组比较,右侧CTN组PAG与双侧前扣带回(ACC)以及右侧缘上回的功能连接增强(多重比较采用GRF校正,P<0.01),并且PAG与双侧ACC功能连接的强度与病程(P=0.007)、疼痛感觉评分(P=0.005)、疼痛情感评分(P=0.006)呈正相关。结论:右侧CTN患者PAG与多个脑区间存在异常的功能连接,为深入了解经典三叉神经痛的中枢机制提供了新的影像学证据。

Objective: To investigate the brain functional connectivity (FC) changes of the periaqueductal gray (PAG) in right classical trigeminal neuralgia (CTN) patients using resting state functional MRI (rs-fMRI). Methods: rs-fMRI data were acquired in 21 right CTN patients and 35 healthy controls (HC).PAG was selected as region of interest (ROI).The linear correlation between PAG and whole brain was calculated and the FC changes were compared between groups.Furthermore,correlation analysis was performed to study whether illness duration and/or pain ratings were related to the abnormal FCs in right CTN group. Results: Compared with the controls,PAG in right CTN group showed a significantly increased FC with bilateral anterior cingulate cortex (ACC) and right supramarginal gyrus (GRF correction for multiple comparisons, P <0.01).Besides,the FC between PAG and bilateral ACC was positively related to the illness duration ( P =0.007),pain sensory rating ( P = 0.005) and pain affective rating ( P =0.006) in right CTN group. Conclusion: This study provides imaging evidence of brain functional integration impairments in right CTN patients,which may contribute to further understanding of the possible central neural mechanisms of CTN.