幻肢痛发生机制的初步研究.docVIP

幻肢痛发生机制的初步研究 四川大学华西医院麻醉科（610041）肖红 中文摘要 目的与背景 关于幻肢痛的发生机制十分复杂至今仍不清楚。fMRI的出现，使人们对于在体脑功能的研究成为可能。本研究拟大脑皮质fMRI激活区域的对比研究，探讨截肢后发生幻肢痛的初步机制 研究对象及方法 选取幻肢痛的患者10名，根据年龄、性别配对的健康志愿者10名以及截肢后无幻肢痛的患者10名，比较比较Zung`S-焦虑、抑郁自评量表健康调查结 果 1.大脑皮质fMRI比较幻肢痛患者“幻肢运动”运动时激活区域为对侧初级感觉运动皮质区及对侧初级运动区即S1/M1区；配对的正常健康志愿者想象与幻肢同侧肢体运动时激活区域为对侧辅助运动区幻肢痛患者刺激及活动幻肢相邻部位时，激活区“侵入”截肢区原代表区，表明有皮质功能重组现象发生；健康志愿者，激活区 “侵入”同侧下肢皮质功能代表区，表明无皮质功能重组现象发生。(P0.05)。 结 论 The mechanism of phantom limb pain: A pilot study in amputees and volunteers Xiaohong, Westchina Hospital of Sichuan University (610041) Abstract Objective and background Phantom limb pain (PLP), i.e., pain that is experienced in a limb that is no longer present, is a common disorder today. Although it is easy to recognize and diagnose, its cause and mechanism remains unclear. The appearance of functional magnetic resonance imaging (fMRI ) makes it possible to study the PLP mechanism in the cortex. The goal of this study is to explore the mechanism of PLP through comparing the differences of the functional connectivity changes in resting-state fMRI study and the cortical areas involved in fMRI tasks, among the PLP patients，the matched healthy controls and the PLP free amputees. Subjects and Methods Ten PLP patients, ten aged-gendered-matched healthy control volunteers and ten PLP free amputees were recruited in this study. The functional connectivity changes in structural and resting-state fMRI study and the cortical areas involved in several fMRI tasks of these patients and healthy controls were recorded. The anxiety and the depression were assessed by Zung’s anxiety and depression scores. The pain intensities were assessed by VAS scales. And the healthy investigations of the amputees and the healthy controls were conducted by SF-36 healthy survey questionnaire. Results Significant regional connection increased in SMA( supplementary motor area, SMA)- insular , SMA-caudate nucleus, SMA-ACC (anterior cingulated cortex，ACC )SMA- hippocampus in the PLP patient