膀胱过度活动症患者大脑功能的连接变化

doi:10.3969/j.issn.1006-9771.2021.04.012

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (4): 466-471.doi: 10.3969/j.issn.1006-9771.2021.04.012

膀胱过度活动症患者大脑功能的连接变化

英小倩^1,²,廖利民^1,^2,^3,⁴()

^1.首都医科大学康复医学院，北京市 100068
^2.中国康复研究中心北京博爱医院，泌尿外科，北京市 100068
^3.中国康复研究中心北京博爱医院，神经泌尿科，北京市 100068
^4.首都医科大学泌尿外科学系，北京市 100069

收稿日期:2021-02-22 修回日期:2021-03-08 出版日期:2021-04-25 发布日期:2021-04-20
通讯作者: 廖利民 E-mail:lmliao@263.net
作者简介:英小倩(1987-)，女，汉族，山东临沂市人，博士研究生，医师，主要研究方向：神经泌尿学与尿动力学，脊髓损伤康复|廖利民(1964-)，男，四川高县人，博士，教授、主任医师、博士生导师，主要研究方向：神经泌尿学与尿动力学。
基金资助:
国家自然科学基金项目(81870523)

Changes of Brain Functional Connections in Patients with Overactive Bladder

Xiao-qian YING^1,²,Li-min LIAO^1,^2,^3,⁴()

^1.Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China
^2.Department of Urology, Beijing Bo'ai Hospital, China Rehabilitation Research Centre, Beijing 100068, China
^3.Department of Neurourology, Beijing Bo'ai Hospital, China Rehabilitation Research Centre, Beijing 100068, China
^4.Department of Urology, Capital Medical University, Beijing 100069, China

Received:2021-02-22 Revised:2021-03-08 Published:2021-04-25 Online:2021-04-20
Contact: Li-min LIAO E-mail:lmliao@263.net
Supported by:
National Natural Scientific Foundation of China(81870523)

摘要/Abstract

摘要： 目的

应用大脑静息态功能磁共振成像(rs-fMRI)技术探索膀胱过度活动症(OAB)的中枢机制。

方法

2019年10月至2021年1月纳入OAB患者13例，平均年龄(46.9±13.4)岁。在尿动力监测下，分别在膀胱空虚和强烈排尿感时进行2次rs-fMRI。采用Matlab2016、SPM12、DPABI软件处理和分析影像数据，提取6个与尿控相关的脑区：右侧额上回(X = 3, Y = 24, Z = 48)，右侧前扣带回(X = 12, Y = 33, Z = 3)，左侧中央后回(X = -18, Y = -26, Z = 48)，右侧辅助运动区(X = 3, Y = -12, Z = 63)，左侧脑岛(X = -42, Y = 12, Z = -3)，右侧脑岛(X = 45, Y = 15, Z = -9)，作为种子点与全脑进行功能连接分析。

结果

右侧额上回与右侧额中回功能连接增加，与右侧楔前叶功能连接减少；右侧前扣带回与右侧颞上回功能连接增加，与左侧后扣带回功能连接减少；左侧中央后回与右侧楔叶功能连接减少；右侧辅助运动区与左侧楔叶功能连接增加；右侧脑岛与内侧额上回功能连接增加；左侧脑岛与顶下小叶功能连接增加。

结论

OAB患者与尿控有关的脑区在储尿期与其他涉及尿控的脑区之间的功能连接发生变化。这种变化可能是OAB的致病机制之一。

关键词: 膀胱过度活动症, 强烈排尿感, 静息态功能磁共振成像, 大脑, 储尿, 功能连接

Abstract: Objective

To explore the central mechanism of overactive bladder (OAB) using the resting-state functional magnetic resonance imaging (rs-fMRI).

Methods

From October, 2019 to January, 2021, 13 patients with OAB aged (46.9 ±13.4) years were enrolled. Under urodynamic monitoring, rs-fMRI scans were performed in these subjects under empty bladder and strong desire to void. Matlab 2016, SPM 12 and DPABI software were used to process and analyze these obtained image data, six brain regions related to bladder control: right superior frontal gyrus (X = 3, Y=24, Z = 48), right anterior cingulate gyrus (X = 12, Y = 33, Z = 3), left postcentral gyrus (X = -18, Y = -26, Z = 48), right supplementary motor area (X = 3, Y = -12, Z = 63), left insular (X = -42, Y = -12, Z = -3) and right insular (X = 3, Y = -12, Z = 63),were extracted as the regions of interest to analyze the functional connection with the whole brain.

Results

The functional connection of the right superior frontal gyrus with the right middle frontal gyrus increased, while the connection with the right cuneus decreased. The connection of the right anterior cingulate gyrus with the right superior temporal gyrus increased, while the connection with the left posterior cingulate gyrus decreased. The connection of the left postcentral gyrus with the right cuneus decreased. The functional connection of the right supplementary motor area with the left cuneus, the connection of the right insular with the medial superior frontal gyrus, and the connection of the left insular with the inferior parietal lobule increased.

Conclusion

The functional connections between the brain areas related to continence and other brain regions involved in bladder control changes in patients with OAB. These changes may be one of the potential pathogenic mechanisms of OAB.

Key words: overactive bladder, strong desire to void, resting-state functional magnetic resonance imaging, brain, urine storage, functional connectivity

中图分类号:

R694

英小倩,廖利民. 膀胱过度活动症患者大脑功能的连接变化[J]. 《中国康复理论与实践》, 2021, 27(4): 466-471.

Xiao-qian YING,Li-min LIAO. Changes of Brain Functional Connections in Patients with Overactive Bladder[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(4): 466-471.

图/表 2

参考文献 34

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膀胱过度活动症患者大脑功能的连接变化

Changes of Brain Functional Connections in Patients with Overactive Bladder

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大脑区域	左/右	体素数	X	Y	Z	t值
ROI 1(额上回)	右
楔叶	右	72	6	-54	33	-8.75
额中回	右	55	24	39	45	10.48
ROI 2(前扣带回)	右
颞上回	右	27	48	12	-24	10.53
后扣带回	左	37	-9	-57	30	-10.98
ROI 3(中央后回)	左
楔叶	右	106	6	-75	27	-12.75
ROI 4(辅助运动区)	右
楔叶	左	30	-9	-75	30	8.12
ROI 5(脑岛)	左
内侧额上回	右	93	24	57	6	31.26
ROI 6(脑岛)	右
顶下小叶	左	44	-33	-60	42	20.55