fmri在功能性慢性內(nèi)臟痛研究中的進展

1、結(jié)語與展望 fMRI在CRD實驗動物中的應(yīng)用 fMRI在臨床IBS病人中的應(yīng)用及進展 目錄 fMRI與功能性慢性內(nèi)臟痛背景簡介 一、 二、 三、 四、 一、fMRI與功能性慢性內(nèi)臟痛背景簡介 計算機體層成像計算機體層成像(CT) 20世紀(jì) 5060年代 7080年 代 8090年 代 19世紀(jì)末 20世紀(jì)初 X 線 放射診斷學(xué) 正電子發(fā)射成像(PET) 單光子發(fā)射體層成像 (SPECT) 磁共振功能成像 （FMRI） 超聲成像(USG) 核素 閃爍成像 (-scintigraphy) 計算機體層成像(CT) 磁共振成像(MRI) 數(shù)字血管減影(DSA) 1.1 醫(yī)學(xué)影像學(xué)發(fā)展簡史 1.2 fM

2、RI歷史 19461973 19921991 19771990 取得了臨床MRI 掃描器的專利； Mansfield使用回波成像(EPI)序列更快的得到圖像 Felix Bloch和Edward Purcell分別發(fā)現(xiàn)了核磁共振(Nuclear Magnetic Resonance)現(xiàn)象 Lauterbur提出NMR 可以用來成像 Ogawa 通過T2加權(quán)像觀察到BOLD 效應(yīng) Belliveau 首次通過對比機制觀察到功能圖像 Ogawa B 、D: 40 mmHg). Anthony C. Johnson et al., Plos One(2010) Wistar大大鼠接受鼠接受CRD的的

3、SPECT局部腦血流局部腦血流 （regional cerebral blood flow，rCBF）顯）顯像像 Fig. 18. Comparison of changes in regional cerebral blood flow-related tissue radioactivity in response to 60-mmHg colorectal distension in female and male rats. Z. Wang et al.,Pain(2009) 目前關(guān)于fMRI在CRD模型所致慢性內(nèi)臟痛的實驗尚未開展。 接受急性結(jié)直腸內(nèi)臟刺激的動物在fMRI中的研究也較

4、少，重復(fù)刺 激和單次刺激的差異與否，不同的給藥途徑，不同藥物的干預(yù)等都 存在較大的科研價值。當(dāng)然fMRI活體動物成像麻醉對實驗存在一 定的影響，但活體成像后動物可以繼續(xù)進行分子生物學(xué)等實驗，在 一定程度上降低了實驗相關(guān)性數(shù)據(jù)的個體差異和組間、組內(nèi)差異， 由此關(guān)于CRD模型在fMRI中的基礎(chǔ)研究亟待開展。 四、結(jié)語與展望 從認(rèn)知神經(jīng)科學(xué)的角度，研究人腦對復(fù)雜任務(wù)的解決固然重要， 但復(fù)雜任務(wù)刺激不利于臨床應(yīng)用； 多數(shù)研究都集中在孤立腦區(qū)的激活與否，沒有考慮腦區(qū)之間的相 互關(guān)系，即忽略了區(qū)域之間時間上的關(guān)聯(lián)性； 通過激活腦區(qū)的功能相關(guān)性，可以為神經(jīng)生物學(xué)、分子生物學(xué)、 藥理學(xué)和行為學(xué)治療等提供更有指

5、導(dǎo)意義的思路； 研究表明臨床上關(guān)于IBS的中樞認(rèn)知處理過程在疾病的發(fā)生發(fā)展中 具有重要作用，但受倫理學(xué)、治療干預(yù)尤其是腦區(qū)等的限制，其 發(fā)展受到一定的阻礙； 由于模型構(gòu)建、小動物磁共振實驗裝置等的限制，目前關(guān)于fMRI 在功能性慢性內(nèi)臟痛實驗動物上的研究甚少，生命早期CRD作為 IBS病人的經(jīng)典模型之一，開展此慢性內(nèi)臟痛動物實驗，實現(xiàn)與臨 床科研之間的生物轉(zhuǎn)化亟待解決。 參考文獻 1.Lazovic, J, Wrzos, H. F, Yang, Q. X, et al. Regional activation in the rat brain during visceral stimulati

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24、T, Sepp M, et al. Common cortical network for first and second painJ. Neuroimage, 2005, 24(1):132142. 謝謝大家！ 1.3 fMRI簡介 功能性磁共振成像（functional Magnetic Resonance Imaging ， fMRI）：是利用磁振造影來測量神經(jīng)元活動所引發(fā)之血液動力的改變。 目前主要是運用在研究人及動物的腦或脊髓。 capillary 含氧血紅蛋白去氧血紅蛋白 Blood Oxygen Level Depend 1.4.2 情緒-覺醒網(wǎng)絡(luò)（emotionalarousal network） 和皮層處理網(wǎng)絡(luò)（和皮層處理網(wǎng)絡(luò)（corticalmodulatory network） Fig. 2. Cortical-affective circuit effective con