中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2022, Vol. 17 ›› Issue (4): 806-811.doi: 10.4103/1673-5374.322471

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

股骨头坏死后感觉运动和疼痛信息处理相关脑区可塑性的变化

  

  • 出版日期:2022-04-15 发布日期:2021-10-18

Surface-based map plasticity of brain regions related to sensory motor and pain information processing after osteonecrosis of the femoral head

Jie Ma1, #, Xu-Yun Hua1, 2, 3, #, Mou-Xiong Zheng2, #, Jia-Jia Wu4, Bei-Bei Huo1, Xiang-Xin Xing1, Sheng-Yi Feng2, Bo Li2, *, Jian-Guang Xu1, 4, *   

  1. 1School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; 2Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China; 3Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University, Shanghai, China; 4Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
  • Online:2022-04-15 Published:2021-10-18
  • Contact: Jian-Guang Xu, MD, PhD, xjg@shutcm.edu.cn; Bo Li, MD, PhD, libo@shyueyanghospital.com.
  • Supported by:
    This study was supported by National Key R&D Program of China, No. 2018YFC2001600 (to JGX); the National Natural Science Foundation of China, Nos. 81802249 (to XYH), 81871836 (to MXZ); a grant from Shanghai Science and Technology Committee of China, Nos. 18511108300 (to JGX), 18441903903900 (to XYH), 18441903800 (to MXZ); Three-Year Action Plan for Traditional Chinese Medicine Development from Shanghai Municipal Health Commission of China, No. ZY(2018-2020)-ZWB-1001-CPJS49 (to BL), ZY(2018-2020)-RCPY-3007 (to JM); Traditional Chinese Medicine Diagnosis and Treatment Technology Improvement Project from Shanghai Municipal Commission of Health and Family Planning of China, No. Zyjx-2017006 (to BL); and Special Project of Postgraduate Innovation Training of China, No. A1-GY20-204-0107 (to JM).

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摘要：

疼痛是髋关节疾病的主要表现之一，可诱导躯体特定区脑电地图可塑性的变化。然而目前大多数研究是基于全脑体积变化的，这可能会导致功能数据的解剖定位不准确，而基于皮质表面的方法可能比使用全脑体积的方法更敏感，更适合全脑研究。此次前瞻性横断面试验在上海中医药大学附属岳阳中西医结合医院纳入20例股骨头坏死患者（12男，8女，年龄56.80±13.60岁）和20例健康对照（9男， 11女，年龄54.56±10.23岁），使用静息态功能磁共振收集影像学资料。结果可见，（1）与健康对照比较，股骨头坏死患者左后外侧前额叶皮质、额叶视野、右侧额叶眼视野和前运动皮质表面局部一致性升高，而右侧初级运动皮质和初级感觉皮质表面局部一致性降低；（2）将表面局部一致性存在显著差异的区域定义为感兴趣区，使用基于种子点的功能连接分析，以研究区域间功能同步。以右侧额叶眼视野和运动前皮质表面局部一致性减少区作为感兴趣区时，股骨头坏死患者右侧中额皮质和右侧下顶皮质功能连接增加，而右侧前中央皮质和右侧中枕叶皮质功能连接降低；（3）与健康对照组相比，股骨头坏死患者岛旁区、岛后区、颞上沟前区、额叶视野和辅助运动皮质厚度减少，且右侧伏隔核皮质下灰质体积减少；（4）提示髋关节疾病患者皮质可塑性的变化主要出现在感觉运动和疼痛相关脑区。试验于2018年8月1日经上海中医药大学附属岳阳中西医结合医院伦理委员会批准（批准号2018-041）。

https://orcid.org/0000-0003-0601-3403 (Jian-Guang Xu); https://orcid.org/0000-0002-3063-6312 (Bo Li)

关键词: 髋关节疾病, 股骨头坏死, 表描脑电地图的可塑性, 局部一致性, 功能连接, 皮质厚度, 皮质下灰质体积, 感觉运动皮质

Abstract: Pain is one of the manifestations of hip disorder and has been proven to lead to the remodeling of somatotopic map plasticity in the cortex. However, most studies are volume-based which may lead to inaccurate anatomical positioning of functional data. The methods that work on the cortical surface may be more sensitive than those using the full brain volume and thus be more suitable for map plasticity study. In this prospective cross-sectional study performed in Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, China, 20 patients with osteonecrosis of the femoral head (12 males and 8 females, aged 56.80 ± 13.60 years) and 20 healthy controls (9 males and 11 females, aged 54.56 ± 10.23 years) were included in this study. Data of resting-state functional magnetic resonance imaging were collected. The results revealed that compared with healthy controls, compared with the healthy controls, patients with osteonecrosis of the femoral head (ONFH) showed significantly increased surface-based regional homogeneity (ReHo) in areas distributed mainly in the left dorsolateral prefrontal cortex, frontal eye field, right frontal eye field, and the premotor cortex and decreased surface-based ReHo in the right primary motor cortex and primary sensory cortex. Regions showing significant differences in surface-based ReHo values between the healthy controls and patients with ONFH were defined as the regions of interests. Seed-based functional connectivity was performed to investigate interregional functional synchronization. When the areas with decreased surface-based ReHo in the frontal eye field and right premotor cortex were used as the regions of interest, compared with the healthy controls, the patients with ONFH displayed increased functional connectivity in the right middle frontal cortex and right inferior parietal cortex and decreased functional connectivity in the right precentral cortex and right middle occipital cortex. Compared with healthy controls, patients with ONFH showed significantly decreased cortical thickness in the para-insular area, posterior insular area, anterior superior temporal area, frontal eye field and supplementary motor cortex and reduced volume of subcortical gray matter nuclei in the right nucleus accumbens. These findings suggest that hip disorder patients showed cortical plasticity changes, mainly in sensorimotor- and pain-related regions. This study was approved by the Medical Ethics Committee of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine (approval No. 2018-041) on August 1, 2018. 

Key words: cortical thickness, functional connectivity, hip disorder, osteonecrosis of the femoral head, ReHo, sensorimotor cortex, surface-based map plasticity, volume of subcortical gray matter nuclei

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