【摘要】 目的：探讨慢性非特异性腰背痛（CNLBP）患者静息态功能磁共振成像（fMRI）改变及其与临床量表间的相关性。方法：对29例CNLBP组与31例健康对照组（HC）进行静息态fMRI扫描和医院焦虑抑郁量表、视觉模拟量表、Oswestry功能障碍指数及腰椎日本骨科学会评分表评估。首先，比较2组间局部一致性（ReHo）和低频振幅（ALFF）的差异；然后，以上述差异脑区为种子点进行2组间功能连接（FC）的比较；最后，提取CNLBP组差异脑区的FC系数与临床量表进行相关性分析。结果：与HC组相比，CNLBP组左侧颞下回ReHo增高；左侧颞下回和左侧眶额上回ALFF增高，左侧颞中回ALFF减低；FC分析结果显示左侧颞中回与右侧额下回三角部FC减低，左侧颞下回与左侧楔前叶FC升高；CNLBP组左侧颞中回与右侧额下回三角回FC系数与视觉模拟量表呈正相关（r=0.527,P=0.003）、与医院焦虑抑郁量表呈负相关（r=-0.383,P=0.040）。结论：CNLBP患者默认网络相关脑区ALFF、ReHo及FC存在异常，可能与疼痛的慢性化及慢性疼痛引发的负性情绪有关。更多还原

【Abstract】 Purpose:To investigate the resting state fMRI changes in patients with chronic nonspecific low back pain (CNLBP) and their correlation with clinical scales.Methods:A total of 29 patients with CNLBP and 31 healthy controls (HC) underwent resting state fMRI scan,and hospital anxiety and depression scale (HADS),visual analogue scale (VAS),Oswestry dysfunction index questionnaire and Japanese Orthopaedic Society lumbar disease score were evaluated.First,regional homogeneity (ReHo) and amplitude of low frequency fluctuation (ALFF) were compared between the two groups.Then,functional connectivity (FC) based on the above significant regions was analyzed and compared between the two groups.Finally,the FC coefficients of different brain regions in CNLBP group were extracted and the correlation with clinical scales was evaluated.Results:Compared with HC group,CNLBP group showed increament of ReHo in the left inferior temporal gyrus and ALFF in the left inferior temporal gyrus and left superior orbitofrontal gyrus,and decrease of ALFF in the left middle temporal gyrus.The FC of the left middle temporal gyrus and the right pars triangularis of inferior frontal gyrus was decreased,and the FC of the left inferior temporal gyrus and the left precuneus was increased in CNLBP group.Correlation analysis showed that the FC coefficients of the left middle temporal gyrus and the right pars triangularis of inferior frontal gyrus were positively correlated with the visual analogue scores(r=0.527,P=0.003)and negatively correlated with the anxiety and depression scale (r=-0.383,P=0.040) in the CNLBP group.Conclusion:CNLBP group showed abnormal ReHo,ALFF and FC in brain regions of the default network,which may be responsible for the chronic pain and the negative emotion caused by chronic pain.更多还原