基于静息态功能MRI低频振幅评价慢性腰痛患者脑功能活动性别差异

Evaluation on gender differences of brain functional activity in chronic low back pain patients based on low frequency amplitude of resting-state functional MRI

目的采用静息态功能MRI(rs-fMRI)低频振幅(ALFF)方法观察男、女性慢性腰痛(CLBP)患者脑功能活动差异。方法前瞻性纳入CLBP患者(CLBP组,n=57)及健康对照者(HC组,n=57),采集rs-fMRI数据,分析CLBP组内不同性别患者及组间存在差异脑区的ALFF值,观察CLBP组内性别间存在差异脑区的ALFF值与视觉模拟评分(VAS)的相关性。结果CLBP组及HC组各含男性24人、女性33人。CLBP组男性右侧三角部额下回、右侧额中回、左侧额上回、双侧内侧额上回ALFF值高于女性(P均<0.05);HC组不同性别间上述脑区ALFF值差异均无统计学意义(P均>0.05)。CLBP组女性双侧小脑7b区、8区和9区ALFF值较HC组女性显著升高(P均<0.05),2组男性间上述脑区ALFF值差异均无统计学意义(P均>0.05)。CLBP组女性右侧额中回ALFF值与VAS评分呈负相关(r=-0.425,P=0.014),女性其余脑区及男性各脑区ALFF值与VAS评分均无明显相关(P均>0.05)。结论不同性别CLBP患者额叶及小脑局部脑区功能活动存在差异。

Objective To explore gender differences of brain functional activity in chronic low back pain(CLBP)patients with amplitude of low frequency fluctuation(ALFF)of resting-state functional MRI(rs-fMRI).Methods rs-fMRI data were prospectively collected from 57 CLBP patients(CLBP group)and 57 healthy controls(HC group).ALFF values of brain areas with significant differences between genders in CLBP group and between groups were observed,and the correlations of ALFF values of brain regions being statistically different between genders in CLBP group and visual analog scale(VAS)scores were analyzed.Results Each of CLBP group and HC group included 24 males and 33 females,respectively.ALFF value of the right triangular inferior frontal gyrus,right middle frontal gyrus,left superior frontal gyrus and bilateral medial superior frontal gyrus in males were higher than those in females in CLBP group(all P<0.05),but not different between males and females in HC group(all P>0.05).ALFF value in bilateral cerebellar regions 7 b,8 and 9 of females in CLBP group were significantly higher than those of females in HC group(all P<0.05),while there was no significant difference of ALFF values of the above regions between males in CLBP group and HC group(all P>0.05).ALFF value of right middle frontal gyrus was negatively correlated with VAS score in females in CLBP group(r=-0.425,P=0.014),while no correlation was found between ALFF values of the other brain areas in females nor males in CLBP group and VAS scores(all P>0.05).Conclusion The functional activities in the frontal lobe and cerebellum were different between male and female CLBP patients.