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目的岛叶皮质在脑内痛觉传导中具有重要作用。本研究旨在用MR波谱测量岛叶前/后和右/左区对实验性诱导三叉神经痛时的代谢变化。方法 16名男性志愿者在接受实验性牙痛的前、中和后均行MR波谱扫描。基于主观疼痛阈值,两相双极电流脉冲持续1ms。志愿者使用MR兼容评定量表对每次刺激做出评价。结果由于疼痛刺激,谷氨酸的绝对值(Glu,F=6.1;P=0.001)、谷氨酰胺的绝对值(Gln,F=11.2;P=0.001)和谷氨酸/谷氨酰胺混合物的绝对值(Glx,F=17.7;P=0.001)显著增加,但是肌醇的绝对值显著下降(mI,F=9.5;P=0.001)。此外,代谢物含量的变化呈明显偏侧化,也就是说,这些代谢物的改变只发生在左侧或者只发生在右侧。肌酸的绝对值也在刺激的过程中显著下降(F=2.8;P=0.022),并且前后侧之间的含量有显著差别(F=40.7;P=0.001)。结论结果表明岛叶皮质是脑内痛觉传导通路中代谢物高活动性的区域。代谢物变化的量化值表明,在急性疼痛中神经代谢物明显活跃但具有区域局限性。要点①牙痛可引起MR波谱可检测的岛叶代谢物的变化。②谷氨酸、谷氨酰胺、谷氨酸/谷氨酰胺混合物和肌醇含量立即变化。③岛叶各区域的代谢物对急性三叉神经痛的反应不同。④各区域代谢物对急性三叉神经痛反应的不同表明细胞结构存在变异。
The purpose of the island of cortex in the brain pain conduction has an important role. The purpose of this study was to measure the metabolic changes in the pre-induction of trigeminal neuralgia using the MR spectroscopy before / after and after the insula. Methods Twenty-six male volunteers underwent MRI scanning before, during and after receiving experimental toothache. Based on the subjective pain threshold, the biphasic current pulse lasts 1 ms. Volunteers used the MR Compatibility Rating Scale to rate each stimulus. Results The absolute value of glutamine (Glu, F = 6.1; P = 0.001), the absolute value of glutamine (Gln, F = 11.2; P = 0.001) and the glutamate / glutamine mixture The absolute value (Glx, F = 17.7; P = 0.001) increased significantly, but the absolute value of inositol decreased significantly (mI, F = 9.5; P = 0.001). In addition, changes in metabolite content were significantly lateralized, that is, changes in these metabolites occurred only on the left or only on the right. The creatine absolute value also decreased significantly during stimulation (F = 2.8; P = 0.022) and there was a significant difference between the anterior and posterior sides (F = 40.7; P = 0.001). Conclusions The results show that the island cortex is a region of high activity of metabolites in the intracerebral pain pathways. Quantification of metabolite changes suggests that neuroleptics are significantly active but have regional limitations in acute pain. Points ① Toothache can cause changes in insular metabolites detected by MR spectroscopy. ② glutamate, glutamine, glutamate / glutamine mixture and inositol content changes immediately. Â ’¢ island leaf metabolites of various regions of acute trigeminal neuralgia different response. (4) The differences in the responses of acute regional triad neuralgia between the regional metabolites showed that there were variations in cell structure.