Department of Radiology, Graduate School of Medicine, The University of Tokyo.
Division of Neuroradiology, Department of Radiology, University of Michigan.
Magn Reson Med Sci. 2024 Apr 1;23(2):204-213. doi: 10.2463/mrms.mp.2022-0099. Epub 2023 Mar 29.
Burning mouth syndrome (BMS) is defined by a burning sensation or pain in the tongue or other oral sites despite the presence of normal mucosa on inspection. Both psychiatric and neuroimaging investigations have examined BMS; however, there have been no analyses using the neurite orientation dispersion and density imaging (NODDI) model, which provides detailed information of intra- and extracellular microstructures. Therefore, we performed voxel-wise analyses using both NODDI and diffusion tensor imaging (DTI) models and compared the results to better comprehend the pathology of BMS.
Fourteen patients with BMS and 11 age- and sex-matched healthy control subjects were prospectively scanned using a 3T-MRI machine using 2-shell diffusion imaging. Diffusion tensor metrics (fractional anisotropy [FA], mean diffusivity [MD], axial diffusivity [AD], and radial diffusivity [RD]) and neurite orientation and dispersion index metrics (intracellular volume fraction [ICVF], isotropic volume fraction [ISO], and orientation dispersion index [ODI]) were retrieved from diffusion MRI data. These data were analyzed using tract-based spatial statistics (TBSS) and gray matter-based spatial statistics (GBSS).
TBSS analysis showed that patients with BMS had significantly higher FA and ICVF and lower MD and RD than the healthy control subjects (family-wise error [FWE] corrected P < 0.05). Changes in ICVF, MD, and RD were observed in widespread white matter areas. Fairly small areas with different FA were included. GBSS analysis showed that patients with BMS had significantly higher ISO and lower MD and RD than the healthy control subjects (FWE-corrected P < 0.05), mainly limited to the amygdala.
The increased ICVF in the BMS group may represent myelination and/or astrocytic hypertrophy, and microstructural changes in the amygdala in GBSS analysis indicate the emotional-affective profile of BMS.
灼口综合征（BMS）的定义为舌部或其他口腔部位出现烧灼感或疼痛感，尽管检查时黏膜正常。精神病学和神经影像学研究都对 BMS 进行了检查；然而，目前还没有使用神经纤维方向分散和密度成像（NODDI）模型进行分析，该模型可提供细胞内和细胞外微观结构的详细信息。因此，我们使用 NODDI 和弥散张量成像（DTI）模型进行体素分析，并比较结果以更好地理解 BMS 的病理学。
前瞻性地使用 3T-MRI 机器对 14 名 BMS 患者和 11 名年龄和性别匹配的健康对照者进行扫描，使用 2 壳层弥散成像。从弥散 MRI 数据中提取弥散张量指标（各向异性分数[FA]、平均弥散度[MD]、轴向弥散度[AD]和径向弥散度[RD]）和神经纤维方向和分散指数指标（细胞内容积分数[ICVF]、各向同性容积分数[ISO]和方向分散指数[ODI]）。这些数据使用基于束的空间统计学（TBSS）和基于灰质的空间统计学（GBSS）进行分析。
TBSS 分析显示，与健康对照组相比，BMS 患者的 FA 和 ICVF 显著升高，MD 和 RD 显著降低（经 FWE 校正 P<0.05）。在广泛的白质区域观察到 ICVF、MD 和 RD 的变化。包括 FA 不同的相当小的区域。GBSS 分析显示，与健康对照组相比，BMS 患者的 ISO 显著升高，MD 和 RD 显著降低（经 FWE 校正 P<0.05），主要局限于杏仁核。
BMS 组的 ICVF 增加可能代表髓鞘形成和/或星形胶质细胞肥大，GBSS 分析中杏仁核的微观结构变化表明 BMS 的情感-情感特征。
