颞下颌关节紊乱病患者静态与动态脑功能异常的磁共振研究

doi:10.7518/hxkq.2021.06.009

华西口腔医学杂志 ›› 2021, Vol. 39 ›› Issue (6): 682-689.doi: 10.7518/hxkq.2021.06.009

颞下颌关节紊乱病患者静态与动态脑功能异常的磁共振研究

尹圆圆¹(), 李飞², 何姝姝¹, 陈嵩¹()

^1.口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院正畸科，成都 610041
^2.四川大学华西医院放射科华西磁共振研究中心，成都 610041

收稿日期:2021-01-11 修回日期:2021-04-19 出版日期:2021-12-01 发布日期:2021-12-03
通讯作者: 陈嵩 E-mail:1042520312@qq.com;songchen882002@hotmail.com
作者简介:尹圆圆，硕士，E-mail：1042520312@qq.com
基金资助:
国家自然科学基金(81400548)

Abnormal static and dynamic brain function in patients with temporomandibular disorders: a resting-state functional magnetic resonance imaging study

Yin Yuanyuan¹(), Li Fei², He Shushu¹, Chen Song¹()

^1.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
^2.Huaxi MR Research Center, Dept. of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China

Received:2021-01-11 Revised:2021-04-19 Online:2021-12-01 Published:2021-12-03
Contact: Chen Song E-mail:1042520312@qq.com;songchen882002@hotmail.com
Supported by:
The National Natural Science Foundation of China(81400548)

摘要/Abstract

摘要： 目的

利用静息态功能磁共振成像技术，结合静态与动态低频振幅（ALFF）分析方法探讨颞下颌关节紊乱病（TMD）患者静息态脑功能活动的改变。

方法

招募30名TMD患者（患者组）和20名健康志愿者（对照组），对所有被试者进行问卷调查和临床检查并行3.0T静息态功能磁共振扫描。基于全脑灰质体素分析静态和动态ALFF的组间差异并进行AlphaSim校正，将存在组间差异的静态和动态ALFF值与临床指标做相关性分析。

结果

与对照组相比，患者组后扣带回的静态和动态ALFF均增加（全脑水平未校正P=0.005；感兴趣区水平AlphaSim校正，体素水平P<0.005，簇水平P<0.05），且后扣带回的动态ALFF与正中关系-最大牙尖交错位不调指数中双侧髁突垂直向不调指数呈负相关。患者组内侧眶额回皮质的动态ALFF也升高（全脑水平AlphaSim校正，体素水平P<0.005，簇水平P<0.05）。

结论

TMD患者后扣带回和内侧眶额回皮质的静息态脑功能活动存在异常改变，可能反映了与患者自我相关思维增加、负面情绪及情绪调节异常相关的潜在中枢改变。

关键词: 颞下颌关节紊乱病, 静息态功能磁共振成像, 脑功能, 静态低频振幅, 动态低频振幅

Abstract: Objective

This study was conducted to investigate the brain function of patients with temporomandibular disorders (TMD) by combining the static and dynamic amplitudes of low-frequency fluctuation (ALFF).

Methods

Thirty patients with TMD and 20 healthy controls were enrolled. All the participants completed their questionnaires, received clinical examinations, and underwent resting-state functional magnetic resonance imaging scanning. We compared the static and dynamic ALFF between the patients and healthy controls by conducting a two-sample t-test with AlphaSim correction for multiple comparisons. The correlation between the static and dynamic ALFF of the brain regions with significant group differences and clinical measurements was analyzed.

Results

The patients with TMD showed increased static and dynamic ALFF in the posterior cingulate cortex compared with that of the controls (whole-brain level, uncorrected P=0.005; region of interest level with AlphaSim correction, voxel level P<0.005, cluster level P<0.05). The dynamic ALFF of the posterior cingulate cortex was negatively correlated with bilateral condylar vertical discrepancies. The dynamic ALFF in the medial orbitofrontal cortex of the patients with TMD was greater than that of the controls (whole-brain level AlphaSim correction, voxel level P<0.005, cluster level P<0.05).

Conclusion

Our findings revealed that the resting-state brain function of the posterior cingulate cortex and the medial orbitofrontal cortex of patient with TMD increased. These changes probably indicated the potential central mechanisms underlying the increased self-relevant thoughts, negative emotion, and abnormal emotion regulation in TMD.

Key words: temporomandibular disorders, resting-state functional magnetic resonance imaging, brain function, static amplitude of low frequency fluctuation, dynamic amplitude of low frequency fluctuation

中图分类号:

R 783.5

尹圆圆, 李飞, 何姝姝, 陈嵩. 颞下颌关节紊乱病患者静态与动态脑功能异常的磁共振研究[J]. 华西口腔医学杂志, 2021, 39(6): 682-689.

Yin Yuanyuan, Li Fei, He Shushu, Chen Song. Abnormal static and dynamic brain function in patients with temporomandibular disorders: a resting-state functional magnetic resonance imaging study[J]. West China Journal of Stomatology, 2021, 39(6): 682-689.

图/表 6

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指标	患者组	对照组	P值
年龄/岁	22.1±3.8	23.1±2.4	0.304
性别（男/女）	11/19	9/11	0.556
身高/cm	166±6.8	165±7.9	0.532
体重/kg	55.1±7.8	57.2±9.8	0.401
教育年限/年	16.2±3.3	17.5±1.3	0.098
抑郁症状等级	0.19±0.22	0.10±0.10	0.094
非特异性躯体症状等级	0.20±0.18	0.15±0.12	0.110
平均FD	0.06±0.02	0.07±0.23	0.479

项目	垂直向		矢状向		横向
项目	左侧髁突	右侧髁突	左侧髁突	右侧髁突	横向
人数	15	16	15	14	19
均值/mm	1.8±1.5	1.9±1.5	1.3±0.9	1.0±0.6	0.8±0.5
范围/mm	0.0～5.0	0.0～5.0	0.0～3.2	0.0～2.0	0.0～2.0

脑区	MNI坐标			体素大小*	T值
脑区	x	y	z	体素大小*	T值
sALFF后扣带回（ROI水平）	0	-36	45	39	4.025
dALFF后扣带回（ROI水平）	-6	-33	42	44	4.178
dALFF内侧眶额皮质（全脑水平）	-15	36	-21	83	3.849

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颞下颌关节紊乱病患者静态与动态脑功能异常的磁共振研究

Abnormal static and dynamic brain function in patients with temporomandibular disorders: a resting-state functional magnetic resonance imaging study

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