背景:使用静息态功能磁共振成像(rs-fMRI)探讨肺部手术后慢性咳嗽患者的孤束核(NTS)功能连接(FC)的改变,以及FC异常与临床量表评分之间的关联。
方法:纳入22例肺部手术后慢性咳嗽患者和22例健康对照者。视觉模拟量表(VAS),莱斯特咳嗽问卷(LCQ-MC)的普通话中文版,汉密尔顿焦虑量表(HAMA)评分,并收集rs-fMRI数据。使用NTS作为种子点进行FC分析,计算全脑所有体素的FC值。采用双样本t检验比较两组间的FC差异。提取具有差异的脑区的FC值并与临床量表评分相关联。
结果:与健康对照相比,肺手术后慢性咳嗽患者的NTS和前扣带回皮质(ACC)的FC值降低(GRF校正,p-voxel<0.005,p-cluster<0.05)与LCQ-MC评分呈正相关(r=0.534,p=0.011),但使用VAS(r=-0.500,p=0.018),HAMA(r=-0.713,p<0.001)评分呈负相关。
结论:NTS伴ACC的FC降低可能与咳嗽超敏反应有关,并可能导致肺部手术后慢性咳嗽患者的焦虑。
To explore the altered functional connectivity (FC) of the nucleus tractus solitarii (NTS) in patients with chronic cough after lung surgery using resting-state functional magnetic resonance imaging (rs-fMRI), and the association between abnormal FC and clinical scale scores.
A total of 22 patients with chronic cough after lung surgery and 22 healthy controls were included. Visual analog scale (VAS), Mandarin Chinese version of the Leicester Cough Questionnaire (LCQ-MC), and Hamilton anxiety rating scale (HAMA) scores were assessed, and rs-fMRI data were collected. The FC analysis was performed using the NTS as the seed point, and FC values with all voxels in the whole brain were calculated. A two-sample t-test was used to compare FC differences between the two groups. The FC values of brain regions with differences were extracted and correlated with clinical scale scores.
In comparison to healthy controls, FC values in the NTS and anterior cingulate cortex(ACC) were reduced in patients with chronic cough after lung surgery (GRF correction, p-voxel < 0.005, p-cluster < 0.05) which were positively correlated with LCQ-MC scores (r = 0.534, p = 0.011), but with VAS (r = -0.500, p = 0.018), HAMA (r = -0.713, p < 0.001) scores were negatively correlated.
Reduced FC of the NTS with ACC may be associated with cough hypersensitivity and may contribute to anxiety in patients with chronic cough after lung surgery.