膝骨关节炎和腰痛患者的脑低频振幅影像学特征比较

doi:10.3969/j.issn.1006-9771.2022.05.016

《中国康复理论与实践》 ›› 2022, Vol. 28 ›› Issue (5): 602-608.doi: 10.3969/j.issn.1006-9771.2022.05.016

膝骨关节炎和腰痛患者的脑低频振幅影像学特征比较

蔡桂燕¹,陈瑞琳¹,徐姝蕊¹,陶静^1,^2,^3,⁴(),刘娇^1,^2,^3,⁴()

1.福建中医药大学康复医学院,福建福州市 350122
2.福建省康复技术重点实验室,福建福州市 350122
3.福建中医药大学康复产业研究院,福建福州市 350122
4.中医骨伤及运动康复教育部重点实验室,福建福州市 350122

收稿日期:2022-01-11 修回日期:2022-04-05 出版日期:2022-05-25 发布日期:2022-06-10
通讯作者: 陶静,刘娇 E-mail:taojing01@163.com;liujiao0415@outlook.com
作者简介:蔡桂燕(1998-),女,汉族,福建漳州市人,硕士研究生,主要研究方向：神经康复与认知科学研究
基金资助:
福建中医药大学康复技术协同创新中心课题(X2021001-协同)

Characteristics of amplitude of low frequency fluctuation in patients with knee osteoarthritis and low back pain

CAI Guiyan¹,CHEN Ruilin¹,XU Shurui¹,TAO Jing^1,^2,^3,⁴(),LIU Jiao^1,^2,^3,⁴()

1. College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, China
2. Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian 350122, China
3. Academy of Rehabilitation Industry, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, China
4. Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Exercise Rehabilitation, Ministry of Education, Fuzhou, Fujian 350122, China

Received:2022-01-11 Revised:2022-04-05 Published:2022-05-25 Online:2022-06-10
Contact: TAO Jing,LIU Jiao E-mail:taojing01@163.com;liujiao0415@outlook.com
Supported by:
Fujian University of Traditional Chinese Medicine of Fujian Rehabilitation Tech Co-Innovation Center Project (X2021001-Collaboration)

摘要/Abstract

摘要：

目的基于静息态功能磁共振成像低频振幅(ALFF)分析方法探讨膝骨关节炎(KOA)和腰痛两种慢性疼痛患者脑影像学特征的异同。方法 2015年8月至2021年9月在福建福州市各社区招募KOA患者16例及年龄、性别相似的健康人16例(对照组1);从Openpain数据库获得27例腰痛患者和年龄、性别相似的健康人32例(对照组2)。比较受试者的ALFF。采用简明疼痛量表(BPI)对KOA患者进行疼痛评分,采用视觉模拟量表(VAS)对腰痛患者进行疼痛评分,并与ALFF进行相关性分析。结果与各自对照组相比,KOA和腰痛患者左前脑岛ALFF降低,KOA患者海马和后扣带回ALFF降低,腰痛患者升高;KOA患者左楔前叶、左中扣带回、右中脑导水管周围灰质区域ALFF降低,右中央前回、中央后回ALFF升高;腰痛患者双前扣带回、双眶部额前回、左背外侧前额叶、右内侧前额叶ALFF降低,右海马旁回、右杏仁核ALFF升高;KOA患者左中扣带回ALFF与BPI评分负相关(r = -0.73, P = 0.003),腰痛患者右海马/杏仁核ALFF与VAS评分正相关(r = 0.73, P = 0.003)。结论不同类型慢性疼痛有共同和特异的脑影像学特征。前脑岛、海马和后扣带回ALFF改变可能是KOA和腰痛的共同病理机制。

关键词: 膝骨关节炎, 腰痛, 慢性疼痛, 功能磁共振成像, 低频振幅

Abstract:

Objective To compare the brain imaging characteristics in patients with knee osteoarthritis (KOA) and low back pain (LBP) based on amplitude of low frequency fluctuation (ALFF) of functional magnetic resonance imaging. Methods From August, 2015 to September, 2021, 16 KOA patients and 16 healthy subjects (controls 1) with similar age and gender were recruited from the communities of Fuzhou, Fujian. Other 27 patients with LBP and 32 healthy subjects (controls 2) with similar age and gender were obtained from the Openpain database. The ALFF were analyzed. KOA patients were assessed the pain with Brief Pain Inventory (BPI), and LBP patients were assessed with Visual Analogue Scale (VAS). The correlation between ALFF and pain scores was analyzed. Results Compared with their own controls, the ALFF decreased in the left anterior insula for both KOA and LBP patients. The ALFF decreased in the hippocampus and posterior cingulate cortex in KOA patients, while increased in LBP patients. ALFF in the left precuneus, left middle cingulate cortex and right periaqueductal gray matter decreased in KOA patients, and ALFF increased in the right precentral/postcentral gyrus. ALFF of bilateral anterior cingulate cortex, bilateral orbital anterior frontal cortex, left dorsolateral prefrontal cortex and right medial prefrontal cortex decreased in LBP patients, and ALFF increased in the right parahippocampal gyrus and right amygdala. ALFF of the left middle cingulate cortex negatively correlated with BPI score in KOA patients (r = -0.73, P = 0.003), and ALFF of the right hippocampus/amygdala positively correlated with VAS score in LBP patients (r = 0.73, P = 0.003). Conclusion There are common and specific brain imaging features in different types of chronic pain. The alteration in the left anterior insula, hippocampus and posterior cingulate gyrus may be the common mechanism for KOA and LBP.

Key words: knee osteoarthritis, low back pain, chronic pain, functional magnetic resonance imaging, amplitude of low frequency fluctuation

中图分类号:

R684

蔡桂燕,陈瑞琳,徐姝蕊,陶静,刘娇. 膝骨关节炎和腰痛患者的脑低频振幅影像学特征比较[J]. 《中国康复理论与实践》, 2022, 28(5): 602-608.

CAI Guiyan,CHEN Ruilin,XU Shurui,TAO Jing,LIU Jiao. Characteristics of amplitude of low frequency fluctuation in patients with knee osteoarthritis and low back pain[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(5): 602-608.

图/表 5

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参考文献 38

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组别	n	性别(男/女)/n	年龄/岁	BPI
HC1组	16	12/4	61.13±4.35	-
KOA组	16	11/5	61.13±4.35	3.38±0.89
χ²/t值		0.155	0.000
P值		0.694	1.000

组别	n	性别(男/女)/n	年龄/岁	VAS ^#
HC2组	32	18/14	30.63±9.25	-
腰痛组	27	12/15	30.89±11.73	4.52±1.75
χ²/t值		0.817	-0.097
P值		0.366	0.864

比较	脑区	体素值	t值	MNI坐标
比较	脑区	体素值	t值	X	Y	Z
HC1组 > KOA组	左楔前叶	156	5.20	-12	-60	42
	左前岛叶	75	5.05	-42	0	-21
	右后扣带回	105	5.14	18	-24	30
	右导水管周围灰质	89	4.99	15	-30	-30
	左中扣带回	83	4.41	-6	9	24
	右海马	69	4.38	39	3	-15
KOA组 > HC1组	右中央前回	101	5.14	48	-6	33
	右中央后回		3.19	51	-21	39

比较	脑区	体素值	t值	MNI坐标
比较	脑区	体素值	t值	X	Y	Z
HC2组 > 腰痛组	左背外侧前额叶	298	4.40	-33	3	36
	左前岛叶	355	4.19	-27	24	-6
	左眶部额前回		3.53	-30	30	0
	左前扣带回		3.32	-12	39	0
	右眶部额前回		3.59	39	33	-6
	右前扣带回		3.17	9	39	12
	右内侧前额叶		3.59	15	33	6
腰痛组 > HC2组	右海马/杏仁核	466	5.37	0	-39	-12
	左后扣带回		3.66	-9	-42	-3
	右海马旁回		3.50	18	-12	-27

膝骨关节炎和腰痛患者的脑低频振幅影像学特征比较

Characteristics of amplitude of low frequency fluctuation in patients with knee osteoarthritis and low back pain

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