基于脑脊同步成像的疼痛表征与调控机制研究
文献类型：学位论文
| 作者 | 魏朝行
|
| 答辩日期 | 2024-06 |
| 文献子类 | 博士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 孔亚卓 |
| 关键词 | 疼痛 疼痛调控 脑脊同步成像 偏侧化 经皮神经电刺激 |
| 学位名称 | 理学博士 |
| 学位专业 | 认知神经科学 |
| 其他题名 | Pain Characterization and Modulation Mechanisms Based on Simultaneous Cortico-Spinal Imaging |
| 中文摘要 | "Understanding and Alleviating Pain" not only signifies a significant objective in medical research but also presents a crucial challenge in enhancing human quality of life. The emergence of simultaneous cortico-spinal fMRI methods over the past decade has opened a new window for non-invasively investigating the characterization and modulation mechanisms of pain throughout the entire central nervous system. This dissertation presents three key studies. Firstly, it introduces and refines a novel simultaneous cortico-spinal fMRI technique, enhancing its applicability for widespread use. Secondly, it uncovers subjective perceptions of pain and the lateralized features of cortico-spinal activation associated with pain representation. Lastly, it elucidates the cortico-spinal mechanisms underlying non-invasive pain modulation techniques. Our research highlights the complexity of pain processing within the central nervous system and offers new perspectives and strategies for clinical pain management. "Understanding and Alleviating Pain" not only signifies a significant objective in medical research but also presents a crucial challenge in enhancing human quality of life. The emergence of simultaneous cortico-spinal fMRI methods over the past decade has opened a new window for non-invasively investigating the characterization and modulation mechanisms of pain throughout the entire central nervous system. This dissertation presents three key studies. Firstly, it introduces and refines a novel simultaneous cortico-spinal fMRI technique, enhancing its applicability for widespread use. Secondly, it uncovers subjective perceptions of pain and the lateralized features of cortico-spinal activation associated with pain representation. Lastly, it elucidates the cortico-spinal mechanisms underlying non-invasive pain modulation techniques. Our research highlights the complexity of pain processing within the central nervous system and offers new perspectives and strategies for clinical pain management. The second study explored the lateralization of pain perception, combining subjective experiences and objective cortico-spinal activations. Systematic assessments of 92 healthy subjects revealed that mechanical sensitivity and responses to identical thermal pain stimuli were consistently higher in the dominant hand. Additionally, activations in the frontal operculum cortex (FOC) and spinal dorsal horn were directly correlated with variations in subjective pain intensity between hands. Structural asymmetry in the bilateral FOC also mirrored these perceptual differences. These findings underscore the interplay between sensory and motor lateralization and indicate that the lateralization of pain perception is shaped by sensory type, stimulation mode, and neuroanatomical structure, enriching our understanding of pain perception and its underlying neural mechanisms. The third study delved into pain modulation mechanisms within the cortico-spinal system, employing transcutaneous electrical nerve stimulation (TENS) as a focal point. This study not only observed the analgesic effects of conventional, acupuncture-like, and sham TENS at the behavioral level but also unveiled their underlying neural modulation mechanisms through simultaneous cortico-spinal imaging. The study found that, regardless of subjective pain perception or objective thermal pain-induced corticospinal activation, conventional TENS primarily induced localized analgesic effects on the treated side, while acupuncture-like TENS diffusely affected both treated and untreated sides. Furthermore, the decending modulation from the brainstem to the cortex, along with direct spinal inhibition, combained contributed to the localized analgesic effects of conventional TENS. In contrast, acupuncture-like TENS induced diffuse analgesic effects through top-down diffuse inhibitory control initiated from the brainstem. This is the first study to use cortico-spinal fMRI to investigate the central analgesic mechanisms of the non-invasive peripheral neural modulation technique, holds significant implications for understanding the analgesic mechanisms of neuromodulation technology. The third study delved into pain modulation mechanisms within the cortico-spinal system, employing transcutaneous electrical nerve stimulation (TENS) as a focal point. This study not only observed the analgesic effects of conventional, acupuncture-like, and sham TENS at the behavioral level but also unveiled their underlying neural modulation mechanisms through simultaneous cortico-spinal imaging. The study found that, regardless of subjective pain perception or objective thermal pain-induced corticospinal activation, conventional TENS primarily induced localized analgesic effects on the treated side, while acupuncture-like TENS diffusely affected both treated and untreated sides. Furthermore, the decending modulation from the brainstem to the cortex, along with direct spinal inhibition, combained contributed to the localized analgesic effects of conventional TENS. In contrast, acupuncture-like TENS induced diffuse analgesic effects through top-down diffuse inhibitory control initiated from the brainstem. This is the first study to use cortico-spinal fMRI to investigate the central analgesic mechanisms of the non-invasive peripheral neural modulation technique, holds significant implications for understanding the analgesic mechanisms of neuromodulation technology. |
| 英文摘要 | 认识疼痛，缓解疼痛，不仅是医学研究的重要目标，也是提高人类生活质量的关键挑战。近年来，脑脊同步功能磁共振成像技术的发展，为无创性地探究大脑和脊髓整个中枢神经系统中疼痛的表征与调控特点提供了一个新的窗口。本文通过三项研究，首先开发并优化了一种更便于推广使用的同步脑脊成像技术；其次，利用该技术揭示了疼痛表征的主观感受和脑脊激活偏侧性特征；最后，阐明了基于外周的非侵入性疼痛调控技术的脑脊机制。这些研究不仅强调了中枢神经系统中疼痛感知和调控的复杂性，还为临床疼痛管理提供了新的视角和策略。 研究一成功开发并优化了脑脊同步成像技术并制定了数据分析方案，为同步精确识别大脑和脊髓水平疼痛和运动诱发激活模式提供了有效工具。本研究克服了以往脑脊同步图像获取的技术困难，采用了同时多层成像技术和并行图像重建， 从而缩短了扫描时间并减少了伪影重叠。在数据分析方面，本研究证明了利用反向相位编码的 B0 场图能够更有效地校正平面回波成像序列导致的图像形变，从而提高了图像配准效率。此外，通过生理噪声去除，可以进一步提高图像时间信 噪比并消除假阳性。同时，本研究提出了针对大脑和脊髓图像的优化分析流程，包括预处理和组水平统计等步骤。在应用方面，通过在两个数据采集站点开展经 典的疼痛和运动任务，证明了本研究提出的图像获取和数据后处理方案的有效性。 研究二从主观感受和客观脑脊激活层面，揭示了疼痛感知的偏侧性特点。通过对 92 名健康被试进行感觉敏感性及热痛诱发脑脊激活的系统测量，本研究发现利手部分区域的机械感觉敏感性高于非利手；对于相同刺激温度的热痛刺激，疼痛强度和不愉悦度主观感受，以及部分皮层和脊髓区域的激活，利手均高于非利手。双侧手的额盖皮层及脊髓背角热痛激活差异, 以及双侧额盖皮层的结构不 对称性程度与主观疼痛强度感受差异呈显著相关。这些发现揭示了感觉偏侧性与运动偏侧性可能存在的关联性，且疼痛感受的偏侧性可能受多重因素影响，包括感觉类型、刺激模式以及神经解剖结构等，为深入理解疼痛感受及其神经机制提 供了新的视角和启示。 研究三以经皮神经电刺激 (TENS) 为例探究了疼痛调控的脑脊机制。这一研究不仅观察到了常规型、针刺样以及假 TENS 在行为层面的镇痛效果，还通过脑脊同步成像技术揭示了其背后的神经调控机制。本研究发现，无论是主观疼痛感受，还是客观热痛诱发脑脊激活，常规型 TENS 主要在治疗侧引发局部镇痛效应，而针刺样 TENS 在治疗侧和非治疗侧产生了弥漫性的镇痛效应。此外，脑干至皮层的下行调控与直接的脊髓抑制共同导致常规型 TENS 的局部镇痛效应，相比之下，针刺样 TENS 通过起始于脑干的自上而下的弥漫性伤害抑制调控导致弥漫性镇痛效应。这是首次利用同步脑脊功能磁共振成像研究非侵入性外周神经调控技术—TENS的镇痛机制，对于理解神经调控技术的镇痛机制具有里程碑意义。 综上所述，本文基于自主开发并优化的脑脊同步功能磁共振成像技术，从疼 痛的表征和疼痛的调控两个维度系统探究了疼痛加工的脑脊机制。这些研究不仅 在技术层面上取得了创新，在理论和实践层面也均有重要贡献，为疼痛科学领域 贡献了新的视角和方法，有望在未来改善疼痛治疗的效率和效果，尤其是在个性化疼痛治疗和非侵入性疼痛调控技术的应用方面。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/48005]  |
| 专题 | 心理研究所_认知与发展心理学研究室 |
| 推荐引用方式 GB/T 7714 | 魏朝行. 基于脑脊同步成像的疼痛表征与调控机制研究[D]. 中国科学院心理研究所. 中国科学院大学. 2024. |
入库方式： OAI收割
来源：心理研究所
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