基于体素形态测量技术对痛性颞下颌关节紊乱病患者脑部体积变化的评估

Evaluation of brain volume changes in patients with painful temporomandibular disorders using voxel-based morphometry

目的采用基于体素的形态测量(voxel-based morphometry,VBM)技术评估痛性颞下颌关节紊乱病(temporomandibular disorders,TMD)患者脑部体积变化。方法纳入2011年11月至2019年12月就诊于解放军总医院及解放军总医院海南医院放射科门诊的146例TMD患者[TMD组,年龄(36.8±15.8)岁,男性44例,女性102例],并招募193名颞下颌关节正常的健康志愿者[健康对照组,年龄(43.3±15.6)岁,男性92名,女性101名],所有受试者均行脑部3.0 TMRI三维结构像扫描。采用VBM技术将三维脑结构像分割成脑灰质、白质及脑脊液图,对脑灰质图像进行双样本t检验,全脑总体积、年龄及性别作为协变量,评估两组受试者脑部体积的变化。结果TMD组患者灰质总体积[(632.4±65.4)ml]显著大于健康对照组[(596.1±76.3)ml](t=4.70,P<0.05)。VBM分析提示TMD组患者脑部体积增加脑区主要位于左侧颞下回、双侧梭状回、双侧颞中回(颞极)及右侧舌回[错误发现率(false discovery rate,FDR)校正,P<0.05]。TMD患者较健康对照组受试者无体积减少脑区。结论颞叶是TMD患者脑部体积增加的靶向性脑区,其神经机制尚待进一步研究。

Objective To evaluate the altered brain volume of the patients with painful temporomandibular disorders(TMD)using voxel-based morphometry(VBM).Methods One hundred forty-six TMD patients[age(36.8±15.8)years,male/female=44/102]and 193 normal controls(NC)[age(43.3±15.6)years,male/female=92/101]were performed with 3 dimensional brain structural images at 3.0 T MR scanner from November 2011 to December 2019 in Department of Radiology,Hainan Hospital and General Hospital of Chinese PLA.The brain structural images were segmented into gray matter,white matter and cerebrospinal fluid,and the gray matter images were performed with two-samples t-test with total intracranial volume,age and gender as covariates.Results The gray matter volume(GMV)presented significantly higher in TMD group[(632.4±65.4)ml]than that in NC group[(596.1±76.3)ml](t=4.70,P<0.05).The brain regions with increased GMV for TMD located in left inferior temporal gyrus,bilateral fusiform gyrus,bilateral middle temporal gyrus and right lingual gyrus compared with NC.Conclusions The temporal lobe was the targeting brain region for TMD patients with increased GMV,which should further be investigated to elucidate the neuromechanism.