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  1. NTU Theses and Dissertations Repository
  2. 醫學院
  3. 腦與心智科學研究所
請用此 Handle URI 來引用此文件: http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/94733
完整後設資料紀錄
DC 欄位值語言
dc.contributor.advisor謝松蒼zh_TW
dc.contributor.advisorSung-Tsang Hsiehen
dc.contributor.author許婷元zh_TW
dc.contributor.authorTing-Yuan Sheuen
dc.date.accessioned2024-08-16T17:52:06Z-
dc.date.available2024-08-19-
dc.date.copyright2024-08-16-
dc.date.issued2024-
dc.date.submitted2024-08-09-
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20.Deng, X., Feng, X., Li, S., Gao, Y., Yu, B., & Li, G. (2015). Influence of the hypothalamic paraventricular nucleus (PVN) on heart rate variability (HRV) in rat hearts via electronic lesion. Bio-medical materials and engineering, 26 Suppl 1, S487–S495. https://doi.org/10.3233/BME-151338
21.Sletten, D. M., Suarez, G. A., Low, P. A., Mandrekar, J., & Singer, W. (2012). COMPASS 31: a refined and abbreviated Composite Autonomic Symptom Score. Mayo Clinic proceedings, 87(12), 1196–1201. https://doi.org/10.1016/j.mayocp.2012.10.013
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dc.identifier.urihttp://tdr.lib.ntu.edu.tw/jspui/handle/123456789/94733-
dc.description.abstract家族性澱粉樣多發性神經病變是一種罕見且致命的遺傳性疾病,由甲狀腺素運載蛋白突變引起,使澱粉樣蛋白沉積在多個器官中而造成多系統疾病,特別是神經系統的損害。自主神經症狀和小纖維神經受損的感覺異常是台灣家族性澱粉樣多發性神經病變患者的早期表現。過去研究大部分是探討臨床症狀與周邊神經機制的關係,但漸漸發現了周邊神經損傷後中樞系統也跟著發生改變。近年來學者使用糖尿病神經病變作為小纖維神經病變模型,發現了病理機制、臨床功能和大腦網路之間的關係,顯示小纖維神經病變並不是純粹的周邊神經系統疾病,而是和中樞神經系統息息相關。因此我們的研究目的是使用機率擴散纖維束成像技術來研究的大腦結構連接變化與臨床症狀的關聯,並在家族性澱粉樣多發性神經病變患者和健康成年人之間的大腦連結性進行組間比較。 研究結果發現心律變異度與腦部造影改變之間存在顯著關聯。大腦導水管周圍灰質與額葉、丘腦、海馬迴、島葉和扣帶回之間的結構性連結和心律變異度呈現正相關,顯示自主神經系統調節越差則導水管周圍灰質結構性連結越低。丘腦與額葉和前扣帶皮層區域之間的結構性連結和 COMPASS31 總分之間呈現負相關,顯示自主神經症狀越多則丘腦結構性連結越低。此外於組間比較中,大腦導水管周圍灰質、杏仁核、下視丘和前島葉結構性連結較低。這些發現暗示大腦結構連接與周圍損傷有關,並可能為我們提供非侵入性生物標記或相關治療的未來候選。zh_TW
dc.description.abstractFamilial amyloid polyneuropathy (FAP) is a group of uncommon, life-threatening hereditary disease due to mutation of transthyretin, causing deposition of amyloid proteins in various organ systems with multisystem disorders, particularly the nervous system. In Taiwan, FAP patients often exhibit early symptoms of small-fiber sensory neuropathy and autonomic dysfunction. Past studies mostly link clinical symptoms to peripheral mechanism, but maladaptive plasticity in the central nervous system following peripheral nerve injury was been found also. Recently, researchers used diabetic neuropathy as a small fiber neuropathy model and found connections among the pathology, clinical function, and brain network, suggesting that SFN is not a pure peripheral nervous system disorder. Our aim is to use probabilistic diffusion tractography to investigate the brain structural connectivity changes correlated with clinical symptoms and examine group comparisons between patients with FAP and healthy adults. Current results showed that a significant association was found between R-R interval variation (RRIV) and brain imaging alterations. A positive correlation was found between the RRIV and SC between the periaqueductal gray (PAG) with frontal, thalamus, hippocampus, insula, and cingulate, indicating that poorer regulation of the autonomic nervous system (ANS) was associated with decreased PAG SC. Negative correlation was found between the COMPASS 31 sum score and SC between the thalamus with the frontal and anterior cingulate cortex(ACC) region, indicating that poorer subjective symptoms was associated with decreased thalamic SC. Furthermore, lower SC was found in PAG, amygdala, hypothalamus, and anterior insula between groups. These findings suggest that brain structural connectivity was correlated with peripheral injury and might provide us a candidate non-invasive biomarker or related treatment in the future.en
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dc.description.tableofcontents誌謝………………………………………………………………………………….......i
中文摘要……………………………………………………………………………..ii-iii
英文摘要……………………………………………………………………………...iv-v
1. INTRODUCTION…………………………………………………………............1-8
1.1 Background of FAP…………………………………………………….………..1
1.2 Pathology of FAP…………………………………………….………………..1-2
1.3 Diagnosis of FAP……………………………………………...…………………2
1.4 Clinical symptoms of FAP…………………………………….………………2-3
1.5 Brain regions related to ANS and pain……………………………...…………3-5
1.6 Introduction of diffusion tensor imaging………………………………………5-6
1.7 Peripheral sensitization to CNS dysfunction in SFN disease………….………6-7
1.8 Peripheral sensitization and its clinical correlations in FAP……...……………..7
1.9 Purpose of this study…………………………………………………..………7-8
2. METHODS……………………………………………………………………….9-16
2.1 Participants………………………………………………………..……………..9
2.2 Image acquisition and preprocessing……………………………..………….9-11
2.3 Probabilistic tractography…………………………………………………..11-12
2.4 Regions of interest for structural connectivity…………...…………………12-13
2.5 Composite Autonomic Symptom Score 31…………………………………….14
2.6 Autonomic clinical symptoms sum score……………………………………....14
2.7 Autonomic Function Tests…………………...……………………………...14-15
2.8 Statistical Analysis………………………………………………………….15-16
3. RESULTS………………………………………………………………….…...17-23
3.1 Clinical presentations of FAP...………………………………………….……..17
3.2 Structural connectivity alterations in FAP.………………………...….……17-21
3.3 Altered PAG connectivity in FAP and its clinical associations………..…..21-23
4. DISCUSSION…………………………………………………………………..24-30
4.1 Impact of reduced structural connectivity in FAP……………….…………24-25
4.2 Association between autonomic regulation and structural connectivity in FAP..26
4.3 Reduced connectivity between thalamus and PAG in chronic pain conditions..27
4.4 HRV alterations in diabetes and FAP: indicators of disease severity and prognosis………………………………………………………………………..27
4.5 Association of subjective ANS symptoms with reduced brain connectivity.28-29
4.6 Comparative analysis of structural connectivity in SFN and FAP …....……….29
4.7 Lack of correlation between IENFd and structural connectivity in FAP: implications for future research…......……………........................................29-30
4.8 Summary………………………………………………………………………..30
5. REFERENCE…………………………………………………………………...31-39
6. LIST OF FIGURES………………………………………………………….….40-50
7. LIST OF TABLES………………………………………………………………51-58
8. ABBREVIATIONS…………………………………………………………….…..59
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dc.language.isoen-
dc.subject機率擴散纖維束成像技術zh_TW
dc.subject家族性澱粉樣多發性神經病變zh_TW
dc.subject大腦導水管周圍灰質zh_TW
dc.subject結構性連結zh_TW
dc.subject心律變異度zh_TW
dc.subjectFamilial amyloid polyneuropathyen
dc.subjectDiffusion tensor imagingen
dc.subjectR-R interval variationen
dc.subjectPeriaqueductal grayen
dc.subjectProbablistic tractographyen
dc.title家族性澱粉樣多發性神經病變自主神經功能障礙的結構連結改變zh_TW
dc.titleAltered structural connectivity underlying dysautonomia in familial amyloid polyneuropathyen
dc.typeThesis-
dc.date.schoolyear112-2-
dc.description.degree碩士-
dc.contributor.coadvisor曾明宗zh_TW
dc.contributor.coadvisorMing-Tsung Tsengen
dc.contributor.oralexamcommittee姚皓傑zh_TW
dc.contributor.oralexamcommitteeHau-Jie Yaoen
dc.subject.keyword家族性澱粉樣多發性神經病變,機率擴散纖維束成像技術,心律變異度,結構性連結,大腦導水管周圍灰質,zh_TW
dc.subject.keywordFamilial amyloid polyneuropathy,Diffusion tensor imaging,Probablistic tractography,Periaqueductal gray,R-R interval variation,en
dc.relation.page59-
dc.identifier.doi10.6342/NTU202404047-
dc.rights.note同意授權(限校園內公開)-
dc.date.accepted2024-08-09-
dc.contributor.author-college醫學院-
dc.contributor.author-dept腦與心智科學研究所-
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