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目的 探讨应用静息态功能磁共振研究耳鸣患者较为一致的活动异常脑区，从而揭示耳鸣患者脑损伤及功能重塑的神经机制。方法 检索1999年1月1日至2023年10月12日采用局部一致性(regional honogeneity,ReHo)及低频振幅(amplitude of low-frequency fluctuation,ALFF)、分数低频振幅指标评估耳鸣患者脑功能改变的文献，按照严格的纳排标准，采用激活似然估计法对既往研究中耳鸣患者相对于健康对照组自发脑神经活动异常的脑区进行整合分析。结果 共纳入22篇29个研究(耳鸣患者746例，健康对照组653例)，联合ALFF、分数低频振幅与ReHo数据Meta分析结果显示，耳鸣患者相对于健康对照组，右颞中回活动增加，并未发现活动减低的脑区；单独ReHo数据分析结果显示，左侧枕中回、左侧后扣带回活动增加；右背外侧额上回、左侧小脑前叶活动减少；单独ALFF数据分析结果显示，耳鸣患者相对于健康对照组未出现任何活动增高或减低的脑区(体素大小≥200 mm3,FDR P<0.05)。结论 运用激活似然估计法-Meta分析方法证实耳鸣患者多个脑区存在自发活动异常，有助于揭示耳鸣脑功能损伤及重塑的神经病理学基础。
Abstract：Objective To identify consistent abnormal brain activity regions in tinnitus patients by resting state functional magnetic resonance imaging(rs-fMRI), and to elucidate neural mechanisms of brain injury and functional remodeling. Methods The literature on local consistency regional honogeneity(ReHo) and low-frequency amplitude(ALFF), fractional low-frequency amplitude(fALFF) indexes used to assess brain function changes in tinnitus patients published up to January 3, 2024, was searched. After screening with the inclusion and exclusion criteria, the activation likelihood estimation method was used to extract information on the brain regions with abnormal spontaneous neural activity in tinnitus patients in selected studies. Results A total of 29 studies from 22 reports(746 cases of tinnitus and 653 cases of control) were included. Meta-analysis of ReHo, ALFF and fALFF data showed increased activity in the right middle temporal gyrus(MTG.R) in tinnitus patients compared with healthy controls, and no brain regions of decreased activities. Analysis of ReHo data element alone revealed increased activity in the left middle occipital gyrus(MOG.L) and left posterior cingulate(PCC.L), and decreased activities in the dorsolateral right superior frontal gyrus(SFGdor.R), left cerebellar anterior lobe(CAL.L). ALFF/fALFF data element analysis alone revealed no brain regions showing increased or decreased activities when compared to healthy controls. Conclusions ALE-Meta analysis confirms abnormal spontaneous activities involving multiple brain regions in patients with tinnitus, which may be helpful to understanding the neuropathological basis of functional brain injury and remodeling in tinnitus.
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基本信息:
中图分类号:R764.45;R445.2
引用信息:
[1]和一帆,王爱杰,黄冉冉,等.耳鸣患者静息态功能磁共振研究的ALE-Meta分析[J].中华耳科学杂志,2026,24(02):118-125.
基金信息:
山东省医药卫生科技项目（202409040614）
2026-02-02
2026-02-02