fmri在功能性慢性內(nèi)臟痛研究中的進展

1、1會計學fmri在功能性慢性內(nèi)臟痛研究中的進展在功能性慢性內(nèi)臟痛研究中的進展計算機體層成像計算機體層成像(CT)20世紀5060年代7080年代8090年代19世紀末20世紀初 X 線 放射診斷學正電子發(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)194619731992199119771990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

2、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 Belliveau 首次通過對比機制觀察到功能圖像 Ogawa & Kwong發(fā)表了通過BOLD 信號成像的結(jié)果capillary含氧血紅蛋白去氧血紅蛋白Blood Oxygen Level Depend功能性慢性內(nèi)臟痛IBSCRDEmeran a. Mayer et al., Gastroenterology(2006)C C穩(wěn)態(tài)傳入網(wǎng)絡包括：臂旁核、丘腦、島葉、dACC等。1.4.1穩(wěn)態(tài)傳入網(wǎng)絡（homeostatic-

3、 afferent network）Figure 1. Ascending projections of homeostatic afferents. (B) Spino-thalamo-cortical system. (C) Cortical modulation of homeostatic afferent input to the central nervous system.Fig. 2. Cortical-affective circuit effective connectivity model.J.S. Labus et al. Pain(2013) 情緒-覺醒環(huán)路: 杏仁核

4、、藍斑復合體、嘴側(cè)/膝下/膝上扣帶回等；皮層處理環(huán)路:前額葉皮質(zhì)、眶顳額葉皮質(zhì)等。Fig. 3. Sex differences in activation of the homeostatic afferent, emotionalarousal, and corticalmodulatory networks in response to noxious visceral stimulation. MaleFemaleZ. Wang et al.,Pain(2009)1.4.3 內(nèi)臟刺激腦部環(huán)路聯(lián)系Figure 4. ReHo differences between IBS patient

5、s and controls. J. KE et al., Neurogastroenterol Motil (2015) 中央后回、丘腦、小腦蚓、頂葉 aMCC、pACC、sACC、vm/dl/vlPFCFigure .5. Rectal distension-induced neural activation in the cingulate cortex (A) and the somatosensory cortex (S1/S2, B).Julia Schmid et al.,Neurogastroenterology(2015)MCC、島葉、丘腦、杏仁核PCCS1、小腦S2S1、S

6、2Figure 6. Major sites of activation differences between irritable bowel syndrome (IBS) and healthy control subjects.C.L. Kwan et al., Neurology(2005)Figure 7. (AD) Brain activation in controls and IBS patients during subliminal and liminal rectal distensions. (E) Seed regions defined in the anterio

7、r insula (left) and aMCC (right) based on rectal distension-induced activation in the control group.(F) Seed regions defined similarly in the bilateral anterior insula (left) and pACC (right) in the IBS patient group.X. L IU，Neurogastroenterol Motil (2015)PCC、PAGaMCC、insula、dmPFC、caudate, and PAG感覺運

8、動皮質(zhì)、 vmPFC運動皮質(zhì) SMA thalamus,SMA,下頂葉Figure 8. (A) Comparis on of brain activation between subliminal and liminal stimulation conditions in the control group. (B) The same in the IBS patient group. (C) Group comparis on of brain activation between controls and IBS patients during subliminal stimulatio

9、n. (D) The same during liminal stimulation.Figure 9 .(A and B) Functional connectivity of the insula seeds in the control and IBS gr oups during liminal stimulation. (C and D) The same in the aMCC (in controls ) and pACC (in IBS patients) seeds during liminal stimulation. (E and F) Group comparisons

10、 of insular and cingulate functional connectivity between controls and IBS patients. (IBS VS. controls: dmPFC, vmPFC, dl PFC, and PCC)dlPFCFig. 10. Sex differences (IBS + HC) for ME-MF (ME-MF = matching emotionmatching form) .J.S. Labus et al. Pain(2013) Fig.11. Disease and sex differences for ME-MF

11、. C. S. H Ubbard et al., Neurogastroenterol Motil (2015)Figure 12。 Statistical T maps for the region of interest analyses for the altering , orienting，and executive control conditions of the Attention Network Test (ANT) .Fig.13. Connections between the main areas activated during visceral perception

12、.X. Moisset et al.,European Journal of Pain (2010)三、fMRI在實驗動物中的應用J. Lazovic et al.,Neurogastroenterol Motil (2005)Figure 14. Axial fMRI images of the rat brain at the pressures of 40 mmHg (A) 60 mmHg (B) and 80 mmHg (C), of the same animal. amygdalaHypothalamus（PVN）NTStrigeminal nucleusFigure 15 .Ax

13、ial fMRI images of the rat brain during the rectal balloon stimulation at the pressure of 60 mmHg (A) and 80 mmHg (B), of the same animal. SCPAGthalamusCblHiIL、PLFigure 16. Specific nuclei activated in rats with CORT (A and C) micropellets but not activated in rats with CHOL (B and D) （A、B：40 mmHg o

14、r；C、D：60 mmHg ）.Figure 17. Specific nuclei activated by 60 mmHg CRD but not at 40 mmHg CRD in rats with either CORT (C and D ) or CHOL (A and B)(A 、C:60 mmHg; B 、D: 40 mmHg).Anthony C. Johnson et al., Plos One(2010)Fig. 18. Comparison of changes in regional cerebral blood flow-related tissue radioac

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