作　　者： (杨璐）; (罗曙光）; (银琼）; (韦静）; (韦淑宝）; (李会会）; (雷毅武）; (秦宇红）;

机构地区： 广西医科大学第一附属医院神经内科,南宁530021

出　　处： 《中华神经科杂志》 2017年第9期655-659,共5页

摘　　要： 目的 比较痉挛性斜颈（ST）患者与健康对照组脑功能活动差异,探讨ST发病机制.方法 纳入广西医科大学第一附属医院2012年11月至2016年1月神经内科门诊就诊的ST患者19例（共收集21例,其中2例因头动平移大于2 mm被剔除）及与之相匹配的健康对照者21名,采用分数低频振幅（fALFF）比较ST组与健康对照组激活差异脑区,并将差异脑区fALFF值与ST症状严重程度（Tsui评分）进行相关性分析.结果 与健康对照组比较,ST组fALFF值升高的脑区有左侧小脑,而左侧扣带回后部/楔前叶、右侧扣带回后部/楔前叶、左侧颞中回、右侧角回、左侧中央后回、右侧辅助运动区fALFF值较健康对照组降低（t=-5.714～ 5.920,均P＜0.01,高斯随机理论的多重比较校正）;上述差异脑区fALFF值与ST患者发病年龄、病程及症状严重程度（Tsui评分）均无相关性（均P＞0.05）.结论 感觉、辅助运动区及小脑、默认网络均可能参与ST的发病. Objective To observe the differences of cerebral activation pattern with resting state functional magnetic resonance imaging （rs-fMRI） between patients with spasmodic torticollis （ST） and healthy controls,thus to investigate the pathogenesis of ST.Methods Nineteen ST patients and 21 age,sex and education-matched healthy controls,recruited from the Department of Neurology,First Affiliated Hospital of Guangxi Medical University between November 2012 and January 2016,were included in this study.rs-fMRI and factional amplitude of low frequency fluctuation （fALFF） were used to obtain differences between patients with ST and healthy controls,and correlative analysis was made on fALFF values of abnormal brain regions and ST patients＇ symptom severity （Tsui scores）.Results Compared with healthy controls,patients with ST had significantly increased fALFF in the left cerebellum and significantly decreased fALFF in the left posterior cingulate cortex/precuneus,right posterior cingulate cortex/precuneus,left middle temporal gyrus,right angular gyrus,left post-central gyrus,right supplementary motor area （t =-5.714-5.920,P 〈0.01）,and abnormal brain regions＇ fALFF values had no correlation with patients＇; age of onset,disease course,symptom severity （P 〉 0.05）.Conclusion Abnormal sensorimotor area,default mode network and cerebellum dysfunction may play a role in the pathophysiology of ST.

关 键 词： 斜颈 磁共振成像 分数低频振幅