中国神经再生研究(英文版) ›› 2021, Vol. 16 ›› Issue (1): 158-165.doi: 10.4103/1673-5374.286971

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

腕管综合征患者大脑神经元活动: 伪连续式动脉自旋标记评估

  

  • 出版日期:2021-01-15 发布日期:2020-11-26

Neural plasticity secondary to carpal tunnel syndrome: a pseudo-continuous arterial spin labeling study

Xue Deng1, Phoebe Lai-Heung Chau2, Suk-Yee Chiu2, Kwok-Pui Leung3, Yong Hu1, Wing-Yuk Ip1, *   

  1. 1 Department of Orthopedics & Traumatology, The University of Hong Kong, Hong Kong Special Administrative Region, China;  2 Clinical Neuro-diagnostic Unit, Tung Wah Hospital, Hong Kong Special Administrative Region, China;  3 Department of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
  • Online:2021-01-15 Published:2020-11-26
  • Contact: Wing-Yuk Ip, MD, wyip@hku.hk.

摘要:

常规功能磁共振成像无法真正反映腕管综合征患者局部脑血流(rCBF)的变化。基于更好的空间分辨率和增加的信噪比的性质,伪连续式动脉自旋标记(pCASL)作为一种有效的非侵入性神经成像技术可用于直接量化大脑区域神经元活动。这项前瞻性观察性研究招募了27例年龄为(57.7±6.51)岁的腕管综合征女性患者,对其进行心理测验、神经传导研究和伪连续式动脉自旋标记神经影像学评估。主成分分析结果确定了皮质、皮质下和大脑的相关激活的脑区与麻木、疼痛、功能、正中神经状态和中位神经运动幅度相关(K = 21-2849r = -0.77- 0.76P <0.05)。在腕管综合征引起的慢性疼痛过程中,疼痛的处理趋势从伤害性环路转变为情感性和认知性环路。这表明在管理腕管综合征患者时,有必要关注被忽视的认知或情绪状态。该研究已于2017411日获得香港大学/香港西部医院管理局的机构审查委员会(HKU/HA HKW IRBUW17-129)批准,并已于2017424日在香港大学试验注册中心注册(HKUCTR-2220)。

https://orcid.org/0000-0003-2966-2588 (Wing-Yuk Ip)

关键词: 腕管综合征, 伪连续式动脉自旋标记, 波士顿腕管问卷, 神经传导研究, 认知, 疼痛, 主成分分析

Abstract: Conventional neuroimaging techniques cannot truly reflect the change of regional cerebral blood flow in patients with carpal tunnel syndrome. Pseudo-continuous arterial spinning labeling (pCASL) as an efficient non-invasive neuroimaging technique can be applied to directly quantify the neuronal activities of individual brain regions that show the persistent symptoms owing to its better spatial resolution and increased signal-to-noise ratio. Therefore, this prospective observational study was conducted in 27 eligible female carpal tunnel syndrome, aged 57.7 ± 6.51 years. Psychometric tests, nerve conduction studies and pCASL neuroimaging assessment were performed. The results showed that the relevant activated brain regions in the cortical, subcrotical, and cerebral regions were correlated with numbness, pain, functionality, median nerve status and motor amplitude of median nerve (K = 21–2849, r = –0.77–0.76, P < 0.05). There was a tendency of pain processing which shifted from the nociceptive circuitry to the emotional and cognitive one during the process of chronic pain caused by carpal tunnel syndrome. It suggests the necessity of addressing the ignored cognitive or emotional state when managing patients with carpal tunnel syndrome. Approval for this study was obtained from the Institutional Review Board  of The University of Hong Kong/Hospital Authority Hong Kong West, China (HKU/HA HKW IRB, approval No. UW17-129) on April 11, 2017. This study was registered in Clinical Trial Registry of The University of Hong Kong, China (registration number: HKUCTR-2220) on April 24, 2017.

Key words: Boston carpal tunnel questionnaire, carpal tunnel syndrome, cognitive, nerve conduction studies, pain, principal component analysis, pseudo-continuous arterial spin labeling