fmri在功能性慢性内脏痛研究中的进展

1、结语与展望 fMRI在CRD实验动物中的应用 fMRI在临床IBS病人中的应用及进展 目录 fMRI与功能性慢性内脏痛背景简介 一、 二、 三、 四、 一、fMRI与功能性慢性内脏痛背景简介 计算机体层成像计算机体层成像(CT) 20世纪 5060年代 7080年 代 8090年 代 19世纪末 20世纪初 X 线 放射诊断学 正电子发射成像(PET) 单光子发射体层成像 (SPECT) 磁共振功能成像 （FMRI） 超声成像(USG) 核素 闪烁成像 (-scintigraphy) 计算机体层成像(CT) 磁共振成像(MRI) 数字血管减影(DSA) 1.1 医学影像学发展简史 1.2 fM

2、RI历史 19461973 19921991 19771990 取得了临床MRI 扫描器的专利； Mansfield使用回波成像(EPI)序列更快的得到图像 Felix Bloch和Edward Purcell分别发现了核磁共振(Nuclear Magnetic Resonance)现象 Lauterbur提出NMR 可以用来成像 Ogawa 通过T2加权像观察到BOLD 效应 Belliveau 首次通过对比机制观察到功能图像 Ogawa B 、D: 40 mmHg). Anthony C. Johnson et al., Plos One(2010) Wistar大大鼠接受鼠接受CRD的的

3、SPECT局部脑血流局部脑血流 （regional cerebral blood flow，rCBF）显）显像像 Fig. 18. Comparison of changes in regional cerebral blood flow-related tissue radioactivity in response to 60-mmHg colorectal distension in female and male rats. Z. Wang et al.,Pain(2009) 目前关于fMRI在CRD模型所致慢性内脏痛的实验尚未开展。 接受急性结直肠内脏刺激的动物在fMRI中的研究也较

4、少，重复刺 激和单次刺激的差异与否，不同的给药途径，不同药物的干预等都 存在较大的科研价值。当然fMRI活体动物成像麻醉对实验存在一 定的影响，但活体成像后动物可以继续进行分子生物学等实验，在 一定程度上降低了实验相关性数据的个体差异和组间、组内差异， 由此关于CRD模型在fMRI中的基础研究亟待开展。 四、结语与展望 从认知神经科学的角度，研究人脑对复杂任务的解决固然重要， 但复杂任务刺激不利于临床应用； 多数研究都集中在孤立脑区的激活与否，没有考虑脑区之间的相 互关系，即忽略了区域之间时间上的关联性； 通过激活脑区的功能相关性，可以为神经生物学、分子生物学、 药理学和行为学治疗等提供更有指

5、导意义的思路； 研究表明临床上关于IBS的中枢认知处理过程在疾病的发生发展中 具有重要作用，但受伦理学、治疗干预尤其是脑区等的限制，其 发展受到一定的阻碍； 由于模型构建、小动物磁共振实验装置等的限制，目前关于fMRI 在功能性慢性内脏痛实验动物上的研究甚少，生命早期CRD作为 IBS病人的经典模型之一，开展此慢性内脏痛动物实验，实现与临 床科研之间的生物转化亟待解决。 参考文献 1.Lazovic, J, Wrzos, H. F, Yang, Q. X, et al. Regional activation in the rat brain during visceral stimulati

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24、T, Sepp M, et al. Common cortical network for first and second painJ. Neuroimage, 2005, 24(1):132142. 谢谢大家！ 1.3 fMRI简介 功能性磁共振成像（functional Magnetic Resonance Imaging ， fMRI）：是利用磁振造影来测量神经元活动所引发之血液动力的改变。 目前主要是运用在研究人及动物的脑或脊髓。 capillary 含氧血红蛋白去氧血红蛋白 Blood Oxygen Level Depend 1.4.2 情绪-觉醒网络（emotionalarousal network） 和皮层处理网络（和皮层处理网络（corticalmodulatory network） Fig. 2. Cortical-affective circuit effective con