黄 东^1，*， 廖潜^1，， 廖琴^2，， 胡蓉^1，， 韩睿^2，

（  1、中南大学湘雅三医院疼痛科；       2、中南大学湘雅三医院麻醉科；  ）

摘要： 目的:探讨静息态功能磁共振成像(fMRI)低频振幅(ALFF)方法评价骨转移癌性疼痛患者的自发性疼痛基线脑活动变化。方法 利用1.5T MRI系统对10名肺癌骨转移疼痛患者及10名年龄、性别相匹配的肺癌无疼痛患者和健康志愿者组分别进行静息态fMRI。静息态f MRI原始数据采用统计参数图软件( SPM8)预处理和静息态磁共振数据分析工具包( REST)进行ALFF分析，采用 SPM8进行t检验统计分析，并用xjView软件确定有统计学意义的脑区解剖位置及MRIcroN软件结果呈现。结果:在静息状态下，发现多个脑区皮层ALFF变化有统计学意义。相对肺癌无疼痛患者组，肺癌骨转移疼痛患者以下脑区ALFF增高，这些脑区包括前扣带回、额内侧回、左枕叶及楔前叶；相对肺癌无疼痛患者组，肺癌骨转移疼痛患者组以下脑区ALFF降低，这些脑区包括颞中回、枕中叶、舌回及枕上叶；相对健康志愿者组，肺癌骨转移疼痛患者以下脑区ALFF增高，包括前扣带回、额内侧回、额上回。肺癌骨转移疼痛患者组以下脑区ALFF降低，包括后扣带回、额下回、颞中回及舌回。结论:第一次表明了骨转移癌性疼痛患者的自发性疼痛的脑区基线脑活动变化的特征，持续自发的疼痛刺激会导致脑区皮层的基线脑活动发生改变，表明应用静息态功能磁共振成像低频振幅方法研究骨转移癌性疼痛患者出现的脑区基线脑活动变化是一种可靠有效的方法。
关键词： 骨转移癌痛；静息态；功能磁共振；低频振幅?????

huang dong^1,*， Liao Qian^1,， Liao Qin^2,， HU Rong^3,， Han Rui^2,

（  1、Pain Management, Third Xiangya Hospital, Central South University ；       2、Department of Anesthesia, Third Xiangya Hospital,Central South University；       3、Pain Management, Third Xiangya Hospital, Central South University ；  ）

Abstract： 0bjective: To study the pain-related baseline brain activity fluctuation of bone metastases pain patients with the method of amplitude of low-frequency fluctuation(ALFF) of resting-state functional MRI．Materials and Methods: 10 patients with pain of bone metastases and 10 matched non-pain lung cancer patients and control group of volunteers were tested in our study. The MRI machine was Siemens 1.5 T scanner．BOLD sequence was used for the resting-state. The data preprocessing was performed using SPM8，the ALFF analysis was performed using REST software.A two-sample t-test was used to examine the differences of ALFF between the metastases pain group and the control group，and the xjView software was used to view the results and the anatomical locations of the ALFF differences between the two groups. and the MRIcroN soft was used to display the results.Results: There were significant differences of ALFF [P<0.005，uncorrected，cluster>405 mm3 (fifteen voxels)] between the groups. Compared with the group of patients with non-pain lung cancer, Areas showing increased ALFF in the bone metastases pain group included the anterior cingulate gyrus、medial frontal gyrus、left occipital lobe and precuneus；Some brain areas showed decreased ALFF in bone metastases pain subjects, these areas included middle temporal gyrus、middle occipital gyrus、lingual gyrus and right superior frontal gyrus;Compared with the volunteer group,Areas showing increased ALFF in the bone metastases pain group included anterior cingulate gyrus、medial frontal gyrus、superior frontal gyrus;Some brain areas showed decreased ALFF in bone metastases pain subjects, these areas included posterior cingulate gyrus、inferior frontal gyrus、middle temporal gyrus and lingual gyrus. Conclusion: This is first study that revealed the changed baseline neuronal activity of spontaneous pain in bone metastases pain subjects, showed that sustained spontaneous pain stimulus may lead to changes in baseline brain activity. Our current study demonstrated the approach that combined resting-state fMRI and ALFF analysis is a reliable and robust way to study changes in baseline brain activity of metastases pain subjects.?????
Keywords： Bone metastases pain；Resting-state; Functional magnetic resonance imaging; Amplitude of low-frequency fluctuation?????

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