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肠易激综合征患者的异常局部一致性:一项静息态功能磁共振成像研究。

Abnormal regional homogeneity in patients with irritable bowel syndrome: A resting-state functional MRI study.

作者信息

Ke J, Qi R, Liu C, Xu Q, Wang F, Zhang L, Lu G

机构信息

Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.

Department of Gastroenterology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.

出版信息

Neurogastroenterol Motil. 2015 Dec;27(12):1796-803. doi: 10.1111/nmo.12692. Epub 2015 Sep 25.

Abstract

BACKGROUND

Task-related brain imaging research has implicated abnormal central processing of visceral sensation in irritable bowel syndrome (IBS). However, how brain function of IBS patients is altered during resting-state remains to be determined. We investigated spontaneous brain activity of patients with IBS using regional homogeneity (ReHo) analysis in resting-state functional magnetic resonance imaging (rs-fMRI).

METHODS

Thirty-one patients with diarrhea-predominant IBS and 32 age- and sex- matched healthy controls underwent clinical assessments and rs-fMRI scanning. ReHo maps were acquired by calculating the Kendall's coefficient of concordance and compared between the IBS group and the control group. The effects of psychological disturbance on group differences were assessed by including anxiety and depression levels as covariates in the statistical analyses. Multiple regression analyses were conducted to examine the relationship between ReHo values and disease duration, symptom severity, and pain intensity.

KEY RESULTS

Compared with controls, IBS patients showed increased ReHo in the postcentral gyrus and thalamus and decreased ReHo in the anterior cingulate cortex and prefrontal cortex. The inclusion of anxiety and depression as covariates did not alter ReHo differences between the two groups. Furthermore, significant correlations were found between clinical indices and ReHo values in some brain regions in the IBS group.

CONCLUSIONS & INFERENCES: IBS patients have abnormal local synchronization of spontaneous brain activity in regions involved in visceral afferent processing, emotional arousal, and cognitive modulation. Combining rs-fMRI and ReHo analysis seems to be a valuable approach to investigate the neural basis of IBS.

摘要

背景

与任务相关的脑成像研究表明,肠易激综合征(IBS)患者存在内脏感觉中枢处理异常。然而,IBS患者在静息状态下脑功能如何改变仍有待确定。我们使用静息态功能磁共振成像(rs-fMRI)中的局部一致性(ReHo)分析,研究了IBS患者的自发脑活动。

方法

31例腹泻型IBS患者和32例年龄及性别匹配的健康对照者接受了临床评估和rs-fMRI扫描。通过计算肯德尔和谐系数获取ReHo图,并在IBS组和对照组之间进行比较。在统计分析中,将焦虑和抑郁水平作为协变量纳入,以评估心理障碍对组间差异的影响。进行多元回归分析,以检验ReHo值与病程、症状严重程度和疼痛强度之间的关系。

主要结果

与对照组相比,IBS患者中央后回和丘脑的ReHo增加,前扣带回皮质和前额叶皮质的ReHo降低。将焦虑和抑郁作为协变量纳入并没有改变两组之间的ReHo差异。此外,在IBS组的一些脑区中发现临床指标与ReHo值之间存在显著相关性。

结论与推论

IBS患者在内脏传入处理、情绪唤醒和认知调节相关区域的自发脑活动存在异常的局部同步性。结合rs-fMRI和ReHo分析似乎是研究IBS神经基础的一种有价值的方法。

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