【作者】 王娟；

【导师】 李小俚；

【作者基本信息】 燕山大学 ， 控制科学与工程， 2015， 博士

【摘要】 慢性痛发病率高、分布范围广、治疗耗时长以及不尽人意的治疗效果使得慢性痛不仅是健康问题,更是社会和经济问题。长期的痛感使得慢性痛患者大脑结构和功能发生改变进而导致各种认知功能的异常。对慢性痛发展和病理特征的理解有助于慢性痛的早期干预和有效治疗。慢性痛是大脑的一种持续痛记忆,而脑电是理解大脑的窗户。因此,应用脑电信号研究慢性痛发展中不同阶段的痛记忆特征以及认知任务下慢性痛患者的病理特征,进一步理解新的慢性痛治疗手段的机理,对慢性痛的有效治疗具有重要的临床意义。本论文致力于研究慢性痛不同发展阶段下的脑电信号特征,分析慢性痛与认知相关的病理特性,探索艾灸治疗慢性痛的效果与大脑神经活动的关系,主要开展了以下研究工作:1.通过大鼠慢性痛造模实验模拟慢性痛发展过程,采用相对功率谱和一致性方法分析在不同造模时间激光刺激下的脑电数据,比较慢性痛不同发展阶段上慢性痛大鼠和对照组大鼠在δ、θ、α、β和γ频段上的功率谱特性和一致性网络特征,提出伤害性刺激诱发的神经活动介导慢性痛发展中痛记忆的形成,发现了不同频段神经活动与慢性痛发展中痛记忆形成的对应关系。2.在理解了慢性痛发展过程的神经活动变化特征基础上,进一步研究了慢性痛患者的认知病理特征。基于小波变换和平行因子相结合的方法,比较了慢性痛患者和健康被试在体感痛刺激和非痛刺激下诱发的脑电信号的时间、频率、空间特征,分析了脑电信号诱发频率与被试年龄之间的相关性。针对oddball范式进一步比较慢性痛患者和健康被试的相位同步差异,发现了慢性痛患者认知功能异常和参与痛处理的脑区内神经活动以及脑区之间相位同步连接的增强有关,对临床上慢性痛治疗具有指导意义。3.基于s LORETA源定位分析方法,研究了临床上慢性腰背痛患者在艾灸治疗前、中、后三个阶段大脑皮层电流源密度的分布特性。以热敏反应和非热敏反应为艾灸镇痛的临床疗效标签,分别比较热敏和非热敏反应的患者在艾灸镇痛前、中、后的电流密度分布差异,发现艾灸治疗慢性痛的临床效果与大脑神经活动的调制有关,艾灸镇痛主要是对前额区、次级体感皮层和扣带区β频段神经活动进行抑制。4.针对临床上部分慢性痛患者对艾灸镇痛不具有热敏反应的现象,本文进一步利用似然同步分析和图论分析,研究了热敏和非热敏慢性痛患者的全局同步强度和网络特征差异,发现非热敏反应患者的大脑网络连接比热敏反应患者具有更好的鲁棒性,而且艾灸镇痛加强了热敏反应患者大脑中与愉悦情绪相关的网络连接。更多还原

【Abstract】 Chronic pain has the charcteristics of high incidence, wide distribution, long treatment time, and unsatisfied curative effect. It is not only a serious health problem but also a social and economic problem. Long-term pain will cause structural and functional changes in brain, and result in a variety of abnormality of cognitive function. Well understanding the development and pathological characteristics of chronic pain will be helpful for early intervention and effective treatment. Chronic pain is belived as constant pain memories of brain, and the Electroencephalogram(EEG) is an effective way to understand the brain. Thus it is significant for guiding clinical chronic pain treatment to study the characteristics of pain memory in different chronic pain development stages and the pathological features of chronic pain patients under cognitive tests. Understanding the mechanism of chronic pain is also helpful to develop new treatment techniques. This paper tried to study the EEG characteristics of different stages of chronic pain, analyze the cognitive pathologies, and explore the relationship between the moxibustion treatment effect and the neural activity in brain. The main research contents of this thesis are listed as follows:1. Based on the chronic pain models built on rats, Charpter 2 studied the EEG characteristics of different stages of chronic pain. Relative time-frequency and coherence methods were applied to analyze the EEG signals collected from the rats under laser stimulation in different modelling stages. The comparison of power spectrum charateristics and network coherence features at delta, theta, alpha, beta, and gamma frequency bands between the chronic pain group and the control group had been made, and the results showed that noxious stimulation mediated the forming of pain memory. Based on the proposed results, the relationship between the neural activity and pain memory forming process was been found.2. Based on the neural activity features of the different development stages of chronic pain revealed in Charpter 2, Chapter 3 further studied the cognitive pathology characteristics of chronic pain patients. Based on wavelet transform and Parallel Factor Analysis methods, this chapter compared the characteristics of EEG signals on time, frequency, and channel dimensions between chronic pain group and control group under painful and nonpainful stimulus, and further analyzed the phase synchronization differences between the two group testees under ddball paradigmand. It was found that cognitive pathologies were associated with the brain neural activity and the enhanced phase synchronization between brain area connection.3. Based on s LORETA source positioning analysis method, Chapter 4 studied the characteristics of current source density distribution of chronic low back pain patients’ EEG signals in pre-moxi, moxi, and post-moxi therapy stages. The non-sensitized and heat-sensitized phenomenas were used as the labels of clinic moxibustion therapy effect, and the differences of current source density distribution between the non-sensitized group and heat-sensitized group in different stages were analyzed. It was found that the clinic effect was associated with modulation of neural activity, where the beta neural oscillation in prefrontal area was inhibited.4. In clinical moxibustion research, not all chronic pain patients were found to be heat-sensitized. Chapter 5 further studied the differences of global synchronization intensity and neural network characteristics. It was found that the connections of brain networks of non-sensitized chronic pain patients had better robustness that that of heat-sensitized chronic pain patients, and the moxibustion strengthened the connections of brain network, which was associated with the euphoriant feeling.更多还原