原发性痛经患者自身不同状态下大脑低频振幅和功能连接的改变:一项基于静息态功能磁共振的研究OA北大核心CSTPCD

Objective: The central mechanisms of pain in patients with primary dysmenorrhea (PDM) were investigated using the amplitude of low frequency fluctuations (ALFF), fractional amplitude of low frequency fluctuations (fALFF), and functional connectivity (FC) methods. Materials and Methods: Thirty-one patients with PDM were included, and all subjects underwent dual-phase resting-state functional magnetic resonance imaging during menstruation and periovulatory. ALFF and fALFF values were calculated, and brain regions with differences in both ALFF and fALFF values were extracted as regions of interest (ROI), and FC values of ROI versus whole-brain voxels were calculated. The paired-sample t-test was used to compare the ALFF, fALFF, and FC values of PDM patients in pain and pain-free states, and Pearson's correlation analysis was used to explore the relationship between the ALFF and fALFF values and the clinical indicators of PDM patients. Results: Compared with the non-painful phase, PDM patients showed significantly higher ALFF values in the left medial superior frontal gyrus and right cerebellar area Ⅱ and significantly lower ALFF values in the left insula during the painful phase (two-tailed test P<0.05, Alphasim-corrected, cluster level>176); fALFF values in the left dorsolateral superior frontal gyrus, left inferior frontal gyrus delta, and right pedunculopontine nucleus during the painful phase of PDM patients were significantly higher than in the non-painful phase, and the fALFF values in the left precuneus were significantly lower than in the non-painful phase (two-tailed test P<0.05, Alphasim corrected, cluster level>154). Subsequently, seed-point-based FC analysis showed that the left superior frontal gyrus was the brain region that differed in both ALFF and fALFF values, and its connectivity with the left cerebellar area Ⅷ was reduced in the painful phase compared to the non-painful phase (two-tailed test P<0.05, Alphasim corrected, cluster level>181); Pearson correlation analysis showed that the left insula in the painful phase of PDM patients ALFF values were negatively correlated with CMSS-t (r=-0.400, P=0.026). Conclusions: The present study reveals abnormal alterations of ALFF and fALFF in PDM and involves multiple brain networks, providing new insights to help understand the central mechanisms of PDM.