基于近红外脑功能成像技术的慢性腰痛患者姿势控制受损的皮质功能机制研究

关键词：慢性腰痛  姿势控制  近红外脑功能成像  氧合血红蛋白浓度  功能连接

Keywords:chronic low back pain  postural control  functional near-infrared spectroscopy  oxygenated hemoglobin concentration  functional connection

摘要：

      摘要 目的：通过近红外脑功能成像技术（fNIRS）技术从“中枢”的角度出发，尝试探究慢性腰痛（chronic low back pain， CLBP）患者姿势控制时大脑皮质的功能是否发生改变，为阐明CLBP的发病机制提供新的思路。 方法：通过Tecno-body和fNIRS检测CLBP患者（30例）与同龄健康人（HC 25例）在4种不同站立任务时，压力中心的位移，以及皮质ROI的HbO、HbR和HbT浓度变化及功能连接情况。 结果：与健康对照（HC）组相比：①CLBP组受试者静态站立任务时COP位移面积明显增大（P<0.05）；②站立任务时，CLBP组受试者大脑皮质M1、PSC、DLPFC及PFC激活程度与健康对照组不同（P<0.05）；③不同站立任务时，部分ROI区功能连接发生了改变（P<0.05）。 结论：与同龄健康人相比，CLBP患者静态站立时姿势控能力明显下降；同时，CLBP患者的PSC区、M1区DLPFC区和PFC区激活程度和功能连接发生了不同程度的改变。这提示CLBP患者面临姿势任务时其感觉、运动皮质区的功能改变可能是导致姿势控制受损的原因之一。

Abstract:

      Abstract Objective：To explore whether the function of the cerebral cortex changes during postural control tasks in patients with chronic low back pain （CLBP）， from a central perspective by using near-infrared functional brain imaging (fNIRS) technology, and to provide new ideas for elucidating the pathogenesis of CLBP. Method：Tecno-body and fNIRS were used to examine the displacement of the center of pressure, as well as the changes in HbO，HbR and HbT concentrations and functional connectivity of the cortical ROI in the patients with CLBP（n=30） and the healthy subjects（n=25） during four different standing tasks.. Result：Compared to the HC group：①the COP displacement area of subjects in the CLBP groups was significantly increased during the four different static standing tasks（P<0.05）；②during the standing tasks， the activation degrees of M1， PSC， DLPFC and PFC in the CLBP group were significantly different from that of the healthy control group（P<0.05）.③the functional connectivity in some ROI areas also significantly changed（P<0.05）. Conclusion：Compared to the age-matched healthy people，the CLBP patients had significantly reduced postural control ability during static standing; meanwhile, the activation and functional connectivity of PSC， M1， DLPFC and PFC were changed in different degrees. These findings indicate that the changes in sensory and motor cortex function may be one of the causes of postural control impairment in patients with CLBP.