Bao Bingbo, Wei Haifeng, Luo Pengbo, Zhu Hongyi, Hu Wencheng, Sun Yi, Shen Junjie, Zhu Tianhao, Lin Junqing, Huang Tengli, Li Jing, Wang Zhibin, Li Yuehua, Zheng Xianyou
Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Front Neurosci. 2021 Jul 20;15:704079. doi: 10.3389/fnins.2021.704079. eCollection 2021.
The right parietal lobe plays an important role in body image, and disorders of body image emerge after lesions in the parietal lobe or with parietal lobe epilepsy. Body image disorder also often accompanies upper-limb amputation, in which the patient misperceives that their missing limb is still part of their body. Cortical reorganization is known to occur after upper-limb amputation, but it is not clear how widespread and to what degree functional connectivity (FC) is reorganized post-amputation, nor whether such changes might be related to misperceptions of body image. Twenty-four subjects who had a traumatically upper-limb amputees (ULAs) and 24 age-matched healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans. Regions of interest (ROIs) in the right superior parietal gyrus (SPG_R) and right inferior parietal lobule (IPL_R) were defined using BrainNet Viewer. We calculated the amplitude of low-frequency fluctuations (ALFF) in ROIs and correlated the ROI mean amplitude of low-frequency fluctuations (mALFF) and mean scores on the phantom limb sensation (PLS) scale and beck depression index (BDI). We also calculated ROIs and whole-brain FC. Compared to the HC group, we observed significantly increased activation (mALFF) in ROIs of the ULA group. Moreover, correlation analyses revealed a significant positive correlation between ROI mALFF and scores on the PLS. There was a significant negative correlation between the SPG_R mALFF and BDI scores. Seed-based, whole-brain FC analysis revealed that FC in the ULA group significantly decreased in many brain regions across the entire brain. The right parietal lobe appears to be involved in some aspect of body awareness and depression in amputation patients. Upper-limb amputation results not only in reorganization in the local brain area formerly representing the missing limb, but also results in more widespread reorganization through FC changes in whole brain.
右顶叶在身体意象中起重要作用，顶叶损伤或患顶叶癫痫后会出现身体意象障碍。身体意象障碍也常伴随上肢截肢出现，此时患者会错误地认为其缺失的肢体仍是身体的一部分。已知上肢截肢后会发生皮质重组，但尚不清楚截肢后功能连接（FC）的重组范围有多广、程度如何，也不清楚这些变化是否可能与身体意象的错误认知有关。24名因外伤导致上肢截肢的受试者（ULAs）和24名年龄匹配的健康对照者（HCs）接受了静息态功能磁共振成像（rs-fMRI）扫描。使用BrainNet Viewer定义右顶上回（SPG_R）和右下顶叶（IPL_R）的感兴趣区域（ROIs）。我们计算了ROIs中的低频波动幅度（ALFF），并将ROIs的低频波动平均幅度（mALFF）与幻肢感觉（PLS）量表和贝克抑郁指数（BDI）的平均得分进行了关联。我们还计算了ROIs和全脑FC。与HC组相比，我们观察到ULA组ROIs中的激活（mALFF）显著增加。此外，相关性分析显示ROI mALFF与PLS得分之间存在显著正相关。SPG_R mALFF与BDI得分之间存在显著负相关。基于种子点的全脑FC分析显示，ULA组全脑多个脑区的FC显著降低。右顶叶似乎参与了截肢患者身体意识和抑郁的某些方面。上肢截肢不仅导致以前代表缺失肢体的局部脑区发生重组，还通过全脑FC变化导致更广泛的重组。
