DTI To Study White Matter Changes Of Lumbar Disc Herniation

Objective: exploring white matter damage on patients with lumbar disc herniation with voxel-based analysis,to understand brain mechanisms during pain caused by lumbar disc herniation(LDH)by analyzing the correlation between DTI parameters and pain intensity or course of the disease.Methods:(1)Study Objects: According to the inclusion and exclusion criteria,18 cases of LDH hospitalized patients confirmed by clinical manifestation,physical examination,CT examination,and MRI examination were recruited for this study.The health control group(HC)was matched with number,age,sex,right handedness,and education level of LHD group.(2)Magnetic resonance imaging: Using the GE DISCOVERY MR 750 3.0T scanner,the acquisition coil was 32 channel head coil,the LDH group and the HC group were subjected to the conventional sequence whole brain scan,excluding the patients with brain organic lesions,the normal subjects can be in the process of DTI data acquisition.(3)Data processing: We adopt the FMRB’s Diffusion Toolbox with in FSL software to analyze all participants cerebral white matter DTI related parameters,including FA(fractional anisotropy),MD(mean diffusivity),λ_‖(axial dispersion coefficient),λ_⊥(radial diffusivity)which were analyzed with SPM8 statistical package based on MATLAB 2010,then recording these brain area which the DTI parameters were significantly different between LDH and HC(P<0.001).Correlation between DTI parameters and course of the disease or Visual Analogue Scale/Score(VAS)were analyzed by Spearmantest.Result:(1)LDH group white matter fiber tracts in the brain FA value decrease is genu of corpus callosum,right thalamus,right frontal lobe(P <0.001,FEW correction).(2)LDH group white matter fiber tracts in the brain FA value increase is Left lenticular nucleus(P < 0.001,FEW correction).(3)LDH group white matter fiber tracts in the brain increased MD value is right anterior lobe of cerebellum,left cerebellum anterior lobe,midbrain,left inferior frontal gyrus,left putamen,genu of corpus callosum,right caudate nucleus(P < 0.001,FEW correction).(4)LDH group white matter fiber tracts in the brain increased λ_‖value is left anterior lobe of cerebellum,right cerebellum anterior lobe,right inferior frontal gyrus,right putamen,right caudate nucleus(P < 0.001,FEW correction).(5)LDH group white matter fiber tracts in the brain increased λ_⊥value is left anterior lobe of cerebellum,right anterior lobe of cerebellum,midbrain,left inferior frontal gyrus,right putamen,corpus callosum,left putamen,right caudate nucleus(P < 0.001,FEW correction).(6)Correlation analysis was not statistically significant between DTI parameters(FA,MD,λ_‖,λ_⊥)and course of the disease or Visual Analogue Scale/Score(VAS)(P > 0.05).Conclusions:(1)The pain caused by LDH may lead to multiple white matter abnormalities in the brain area,involving pain perception,emotion,cognition and so on.(2)Some brain areas of LDH patients increased FA value,does this mean that part of the white matter fiber conduction ability of compensatory enhancement,is that an effective compensatory mechanism still needs further study.(3)DTI analysis technology can provide functional neuroanatomical evidence for mechanisms of LDH induced chronic pain.