王煜明1，方继良1，崔炳南 1

（1中国中医科学院广安门医院,北京，100053）

摘要：慢性自发性荨麻疹（CSU）是一种常见的瘙痒性皮肤病，其神经病理学机制尚未明确。在本研究中，我们探讨了CSU的静息状态功能连通性（rs-FC）变化，以及干预后症状改变如何对rs-FC进行调节。研究招募了40名患者和40名健康人。干预从第一次扫描开始约6周，32例患者参加了第二次扫描。与HCs相比，CSU受试者在小脑中表现出更高的区域同质性（ReHo）值，与基线时的uticaria活动评分（UAS7）呈正相关。干预后，伴随临床改善，我们发现ReHo值在小脑下降，双侧SI / MI / SMA增加。使用小脑作为种子，与HCs相比，CSU受试者表现出具有奖励区域的rs-FC增加，并且在干预后在右侧眶额叶皮层和右侧感觉运动区域显示出减少的rs-FC。改善率值与两个区域的rs-FC值减少呈正相关。使用SI / MI / SMA组作为种子，CSU患者在干预后表现出左侧壳核，尾状核，伏隔和丘脑的rs-FC减少。该结果表明CSU存在小脑活动和小脑 - 奖励-感觉运动通路的障碍。

关键词：静息态功能磁共振成像；瘙痒；慢性自发性荨麻疹；小脑；奖励；感觉运动

The dysfunction of the cerebellum and its cerebellum-reward-sensorimotor loops in chronic spontaneous urticaria (CSU)

WANG Yuming 1, FANG Jiliang 1, CUI Bingnan 1

(Guang’anmen Hospital,China Academy of Chinese Medical Sciences, Beijing 100053)

Abstract: Chronic spontaneous urticaria (CSU) is a common itchy skin disease. The neuropathology of CSU is uncertain. In this study, we explored the resting state functional connectivity (rs-FC) changes in CSU, as well as how the symptom changes following intervention can modulate the rs-FC. 40 patients and 40 healthy individuals were recruited. Following intervention, 32 patients participated in a second scan about 6 weeks after the first scan. Compared with HCs, CSU subjects exhibited higher regional homogeneity (ReHo) values in the cerebellum, which was positively associated with uticaria activity scores (UAS7) at baseline. After intervention, accompanied with clinical improvement, we found ReHo values decreased at cerebellum and increased at bilateral SI/MI/SMA. Using the cerebellum as a seed, CSU subjects exhibited increased rs-FC with reward regions when compared with HCs, and exhibited decreased rs-FC at the right orbitofrontal cortex and right sensorimotor region after intervention. The improvement rate values were positively associated with reduced rs-FC values in the two regions. Using the cluster of SI/MI/SMA as a seed, CSU patients exhibited decreased rs-FC with the left putamen, caudate, accumbens, and thalamus after intervention. This results identifies the altered cerebellar activity and cerebellum-reward-sensorimotor loops in CSU.

Key words:Resting-state functional magnetic resonance imaging (rs-fMRI); Itch;Chronic spontaneous urticarial; Cerebellum; reward;sensorimotor