带状疱疹后神经痛患者的脑自发活动改变:一项基于rs-fMRI数据的ALE元分析

Changes in spontaneous brain activity in patients with postherpetic neuralgia:An ALE Meta-analysis based on rs-fMRI data

目的探讨带状疱疹后神经痛(postherpetic neuralgia,PHN)患者的脑自发活动改变特点,从而揭示PHN可能的神经机制,为后期通过PHN患者的脑自发活动改变客观评估PHN治疗疗效奠定基础。材料与方法在线检索PubMed、The Cochrane Library、EMBase、Medine、Web of Science、中国知网、中国生物医学文献数据库(CBM)、维普网和万方数据知识服务平台数据库中采用局部一致性(regional homogeneity,ReHo)及低频振幅(amplitude of low-frequency fluctuation,ALFF)/比率低频振幅(fractional amplitude of low-frequency fluctuation,fALFF)分析方法研究PHN患者脑自发活动改变的文献。采用激活似然估计法(activation likelihood estimation,ALE)对纳入研究中PHN患者相对于健康对照组(healthy controls,HCs)出现脑自发活动异常改变的脑区进行元分析。结果共纳入11篇文献16个研究,包括5项ReHo研究、4项ALFF研究及7项fALFF研究,共计PHN患者200名,HCs 236名。联合ALFF/fALFF及ReHo研究的数据进行元分析结果显示:PHN患者相对于HCs右侧额中回、右侧丘脑、左侧纹状体及右侧楔叶脑自发活动增高,而右侧颞叶及右侧海马旁回脑自发活动减低。单独使用ALFF/fALFF研究的数据进行元分析结果显示:PHN患者相对于HCs右侧额中回、右侧丘脑及左侧纹状体脑自发活动增高,并未发现脑自发活动减低的脑区;单独使用ReHo研究的数据进行元分析结果显示,PHN患者相对于HCs未出现脑自发活动增高或减低的脑区。结论本文通过ALE元分析的方法,基于目前已有的rs-fMRI全脑研究数据,发现PHN患者脑自发活动改变脑区可能为右侧额中回、右侧丘脑、左侧纹状体、右侧楔叶、右侧颞叶及右侧海马旁回,为后期通过PHN患者的脑自发活动改变客观评估PHN治疗疗效提供了重要依据。

Objective:To explore the characteristics of spontaneous brain activity changes in patients with postherpetic neuralgia(PHN),so as to reveal the possible neural mechanism of PHN,and lay a foundation for the objective evaluation of the therapeutic effect of PHN through the changes of spontaneous brain activity in the later stage.Materials and Methods:PubMed,The Cochrane Library,EMBase,Medine,and Web of Science,CNKI,CBM,VIP database and Wanfang Data Knowledge service Platform were searched for literatures,which study the changes of brain basal activity in patients with PHN using regional homogeneity(ReHo)and amplitude of low-frequency fluctuation(ALFF)/fractional amplitude of low-frequency fluctuation(fALFF)analysis methods.Activation likelihood estimation(ALE)was used to perform a Meta-analysis of the brain regions with spontaneous brain activity changes in PHN patients compared with healthy controls(HCs).Results:A total of 16 studies from 11 articles were included,including 5 ReHo studies,4 ALFF studies and 7 fALFF studies,with a total of 200 PHN patients and 236 HCs.Combined with the data from the ALFF/fALFF and ReHo studies,the Meta-analysis results showed that compared with HCs,PHN patients had increased spontaneous brain activity in the right middle frontal gyrus,right thalamus,left striatum and right cuneus,while decreased spontaneous brain activity in the right temporal lobe and right parahippocampal gyrus.Meta-analysis using ALFF/fALFF data alone showed that compared with HCs,PHN patients had increased spontaneous brain activity in the right middle frontal gyrus,right thalamus and left striatum,but no decreased spontaneous brain activity was found.Meta-analysis using data from ReHo study alone showed that there were no regions with increased or decreased spontaneous brain activity in PHN patients compared with HCs.Conclusions:In this paper,through the ALE Meta-analysis method,based on the data of reported rs-fMRI whole brain studies,we find that PHN patients have spontaneous brain activity changes in the right middle frontal gyrus,right thalamus,left striatum,right cuneus,right temporal lobe and right parahippocampal gyrus.This provides an important basis for objective evaluation of PHN treatment efficacy through changes in spontaneous brain activity.