静息态功能磁共振下探究前额叶在慢性主观性耳鸣中的作用

The role of the prefrontal cortex in chronic subjective tinnitus: insights from resting-state fMRI

施超旗;倪嘉俞;金恩丽;殷子力;秦梨;李圆

1:浙江省肿瘤医院耳鼻咽喉头颈外科

2:杭州师范大学附属医院耳鼻咽喉头颈外科

3:杭州市第九人民医院耳鼻咽喉科

4:杭州师范大学临床医学院

摘要
目的 利用静息态功能磁共振(resting-state functional MRI,rs-fMRI)探究前额叶皮层在慢性主观性耳鸣的发生和适应中的作用。方法 选取20例慢性主观性耳鸣患者和同期招募的20例健康对照组进行静息态功能磁共振成像扫描,运用分数低频振幅(fractional amplitude of low frequency fluctuation, fALFF)和基于种子点的全脑功能连接(functional connectivity, FC)指标,探测慢性主观性耳鸣患者前额叶异常脑活动与耳鸣感知脑区间的交互作用,分析前额叶异常脑活动、脑区间的功能连接改变与耳鸣临床特征间的关系。结果 与健康对照组相比,慢性耳鸣患者前额叶皮层的一些特定的脑区表现出fALFF值显著降低,包括左、右内侧额上回和左、右侧额中回。其中左内侧额上回与左侧前脑岛、左侧前扣带回间的功能连接值增强,右内侧额上回与左侧颞上回、右侧额下回间的功能连接值增强,左侧额中回与右侧颞中回、右侧颞上回间的功能连接值增强,右侧额中回与左侧海马旁回、左侧顶上回、左侧辅助运动区的功能连接值增强。其中左侧额中回与右侧颞上回的功能连接程度与耳鸣致残量表评分(r=-0.627,P=0.003)及视觉模拟评分(r=-0.596,P=0.005)呈负相关。结论 慢性主观性耳鸣患者的内侧前额叶和背外侧前额叶皮层存在脑功能异常变化,伴随着与突显网络、听觉皮层等脑区间功能连接强度的改变,这些异常与耳鸣的严重程度高度相关。前额叶皮层可能在耳鸣的感觉预测和听觉调控中发挥作用。
关键词
慢性主观性耳鸣;静息态功能磁共振;前额叶皮层;分数低频振幅;功能连接
基金项目(Foundation):
浙江省医药卫生科技计划项目(2023XY043)
作者
施超旗;倪嘉俞;金恩丽;殷子力;秦梨;李圆
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