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Livny A, Golan Y, Itzhaki N, Grossberg D, Tsarfaty G, Bondi M, Zeilig G, Defrin R. Higher Regional Gray Matter Volume and White Matter Integrity in Individuals With Central Neuropathic Pain After Spinal Cord Injury. J Neurotrauma 2024; 41:836-843. [PMID: 37937697 DOI: 10.1089/neu.2023.0146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
Abstract
Spinal cord injury (SCI) is a debilitating neurological condition that often leads to central neuropathic pain (CNP). As the fundamental mechanism of CNP is not fully established, its management is one of the most challenging problems among people with SCI. To shed more light on CNP mechanisms, the aim of this cross-sectional study was to compare the brain structure between individuals with SCI and CNP and those without CNP by examining the gray matter (GM) volume and the white matter (WM) integrity. Fifty-two individuals with SCI-28 with CNP and 24 without CNP-underwent a magnetic resonance imaging (MRI) session, including a T1-weighted scan for voxel-based morphometry, and a diffusion-weighted imaging (DWI) scan for WM integrity analysis, as measured by fractional anisotropy (FA) and mean diffusivity (MD). We found significantly higher GM volume in individuals with CNP compared with pain-free individuals in the right superior (p < 0.0014) and middle temporal gyri (p < 0.0001). Moreover, individuals with CNP exhibited higher WM integrity in the splenium of the corpus callosum (p < 0.0001) and in the posterior cingulum (p < 0.0001), compared with pain-free individuals. The results suggest that the existence of CNP following SCI is associated with GM and WM structural abnormalities in regions involved in pain intensification and spread, and which may reflect maladaptive neural plasticity in CNP.
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Affiliation(s)
- Abigail Livny
- Division of Diagnostic Imaging, Sheba Medical Center, Tel HaShomer, Israel
- Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol Neuroscience School, Tel Aviv University, Tel Aviv, Israel
| | - Yael Golan
- Division of Diagnostic Imaging, Sheba Medical Center, Tel HaShomer, Israel
| | - Nofar Itzhaki
- Division of Diagnostic Imaging, Sheba Medical Center, Tel HaShomer, Israel
| | - Dafna Grossberg
- Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Rehabilitation Ambulatory Department, Sheba Medical Center, Tel HaShomer, Israel
| | - Galia Tsarfaty
- Division of Diagnostic Imaging, Sheba Medical Center, Tel HaShomer, Israel
- Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Bondi
- Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Neurological Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel
| | - Gabriel Zeilig
- Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Neurological Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel
- School of Health Professions, Ono Academic College, Kiryat Ono, Israel
| | - Ruth Defrin
- Sagol Neuroscience School, Tel Aviv University, Tel Aviv, Israel
- Department of Physical Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Čeko M, Baeuerle T, Webster L, Wager TD, Lumley MA. The effects of virtual reality neuroscience-based therapy on clinical and neuroimaging outcomes in patients with chronic back pain: a randomized clinical trial. Pain 2024:00006396-990000000-00549. [PMID: 38466872 DOI: 10.1097/j.pain.0000000000003198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/06/2024] [Indexed: 03/13/2024]
Abstract
ABSTRACT Chronic pain remains poorly managed. The integration of immersive technologies (ie, virtual reality [VR]) with neuroscience-based principles may provide effective pain treatment by targeting cognitive and affective neural processes that maintain pain and therefore potentially changing neurobiological circuits associated with pain chronification and amplification. We tested the effectiveness of a novel VR neuroscience-based therapy (VRNT) to improve pain-related outcomes in n = 31 participants with chronic back pain, evaluated against usual care (waitlist control; n = 30) in a 2-arm randomized clinical trial (NCT04468074). We also conducted pre-treatment and post-treatment MRI to test whether VRNT affects brain networks previously linked to chronic pain and treatment effects. Compared with the control condition, VRNT led to significantly reduced pain intensity (g = 0.63) and pain interference (g = 0.84) at post-treatment vs pre-treatment, with effects persisting at 2-week follow-up. These improvements were partially mediated by reduced kinesiophobia and pain catastrophizing. Several secondary clinical outcomes were also improved by VRNT, including disability, quality of life, sleep, and fatigue. In addition, VRNT was associated with increases in dorsomedial prefrontal functional connectivity with the superior somatomotor, anterior prefrontal and visual cortices, and decreased white matter fractional anisotropy in the corpus callosum adjacent to the anterior cingulate, relative to the control condition. Thus, VRNT showed preliminary efficacy in significantly reducing pain and improving overall functioning, possibly through changes in somatosensory and prefrontal brain networks.
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Affiliation(s)
- Marta Čeko
- Institute of Cognitive Science, University of Colorado, Boulder, CO, United States
| | | | - Lynn Webster
- U.S. Center for Policy, Scientific Affairs, Dr. Vince Clinical Research, Salt Lake City, UT, United States
| | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States
| | - Mark A Lumley
- Department of Psychology, Wayne State University, Detroit, MI, United States
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Tu Y, Wang J, Li Z, Xiong F, Gao F. Topological alterations in white matter structural networks in fibromyalgia. Neuroradiology 2023; 65:1737-1747. [PMID: 37851020 DOI: 10.1007/s00234-023-03225-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/19/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE Neuroimaging studies employing analyses dependent on regional assumptions and specific neuronal circuits could miss characteristics of whole-brain structural connectivity critical to the pathophysiology of fibromyalgia (FM). This study applied the whole-brain graph-theoretical approach to identify whole-brain structural connectivity disturbances in FM. METHODS This cross-sectional study used probabilistic diffusion tractography and graph theory analysis to evaluate the topological organization of brain white matter networks in 20 patients with FM and 20 healthy controls (HCs). The relationship between brain network metrics and clinical variables was evaluated. RESULTS Compared with HCs, FM patients had lower clustering coefficient, local efficiency, hierarchy, synchronization, and higher normalized characteristic path length. Regionally, patients demonstrated a significant reduction in nodal efficiency and centrality; these regions were mainly located in the prefrontal, temporal cortex, and basal ganglia. The network-based statistical analysis (NBS) identified decreased structural connectivity in a subnetwork of prefrontal cortex, basal ganglia, and thalamus in FM. There was no correlation between network metrics and clinical variables (false discovery rate corrected). CONCLUSIONS The current research demonstrated disrupted topological architecture of white matter networks in FM. Our results suggested compromised neural integration and segregation and reduced structural connectivity in FM.
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Affiliation(s)
- Ye Tu
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jihong Wang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zheng Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Xiong
- Department of Radiology, PLA Central Theater General Hospital, Wuhan, China.
| | - Feng Gao
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
- Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
- Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Izuno S, Yoshihara K, Hosoi M, Eto S, Hirabayashi N, Todani T, Gondo M, Hayaki C, Anno K, Hiwatashi A, Sudo N. Psychological characteristics associated with the brain volume of patients with fibromyalgia. Biopsychosoc Med 2023; 17:36. [PMID: 37875931 PMCID: PMC10594713 DOI: 10.1186/s13030-023-00293-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023] Open
Abstract
Fibromyalgia (FM) is a disease characterized by chronic widespread pain concomitant with psychiatric symptoms such as anxiety and depression. It has been reported that FM patients engage in pain catastrophizing. In this study, we investigated characteristics of the brain volume of female FM patients and the association between psychological indices and brain volume. Thirty-nine female FM patients and 25 female healthy controls (HCs) were recruited for the study, and five FM patients were excluded due to white matter lesions. The following analyses were performed: (1) T1-weighted MRI were acquired for 34 FM patients (age 41.6 ± 7.4) and 25 HCs (age 39.5 ± 7.4). SPM12 was used to compare their gray and white matter volumes. (2) Data from anxiety and depression questionnaires (State-Trait Anxiety Inventory and Hospital Anxiety and Depression Scale), the Pain Catastrophizing Scale (subscales rumination, helplessness, magnification), and MRI were acquired for 34 FM patients (age 41.6 ± 7.4). Correlation analysis was done of the psychological indices and brain volume. We found that (1) The white matter volume of the temporal pole was larger in the FM patient group than in the HC group. (2) Correlation analysis of the psychological indices and gray matter volume showed a negative correlation between trait anxiety and the amygdala. For the white matter volume, positive correlations were found between depression and the brainstem and between magnification and the postcentral gyrus. Changes in the brain volume of female FM patients may be related to anxiety, depression, and pain catastrophizing.
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Grants
- JP16K15414 Ministry of Education, Culture, Sports, Science and Technology
- JP19H03752 Ministry of Education, Culture, Sports, Science and Technology
- JP20K03417 Ministry of Education, Culture, Sports, Science and Technology
- JP19FG2001 Ministry of Health, Labour and Welfare
- JP20FC1056 Ministry of Health, Labour and Welfare
- JP19ek0610015h0003 Japan Agency for Medical Research and Development
- JP19dm0307104 Japan Agency for Medical Research and Development
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Affiliation(s)
- Satoshi Izuno
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, Fukuoka, 812-8582, Japan
| | - Kazufumi Yoshihara
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, Fukuoka, 812-8582, Japan.
| | - Masako Hosoi
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
| | - Sanami Eto
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, Fukuoka, 812-8582, Japan
| | | | - Tae Todani
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, Fukuoka, 812-8582, Japan
| | - Motoharu Gondo
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Chie Hayaki
- Department of Psychosomatic Medicine, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - Kozo Anno
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
| | - Akio Hiwatashi
- Department of Radiology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka, Fukuoka, 812-8582, Japan
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
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Čeko M, Baeuerle T, Webster L, Wager TD, Lumley MA. The Effects of Virtual Reality Neuroscience-based Therapy on Clinical and Neuroimaging Outcomes in Patients with Chronic Back Pain: A Randomized Clinical Trial. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.24.23293109. [PMID: 37546872 PMCID: PMC10402228 DOI: 10.1101/2023.07.24.23293109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Chronic pain remains poorly managed. The integration of innovative immersive technologies (i.e., virtual reality (VR)) with recent neuroscience-based principles that position the brain as the key organ of chronic pain may provide a more effective pain treatment than traditional behavioral therapies. By targeting cognitive and affective processes that maintain pain and potentially directly changing neurobiological circuits associated with pain chronification and amplification, VR-based pain treatment has the potential for significant and long-lasting pain relief. We tested the effectiveness of a novel VR neuroscience-based therapy (VRNT) to improve pain-related outcomes in n = 31 participants with chronic back pain, evaluated against usual care (n = 30) in a 2-arm randomized clinical trial ( NCT04468074) . We also conducted pre- and post-treatment MRI to test whether VRNT affects brain networks previously linked to chronic pain and treatment effects. Compared to the control condition, VRNT led to significantly reduced pain intensity (g = 0.63) and pain interference (g = 0.84) at post-treatment vs. pre-treatment, with effects persisting at 2-week follow-up. The improvements were partially mediated by reduced kinesiophobia and pain catastrophizing. Several secondary clinical outcomes were also improved, including disability, quality of life, sleep, and fatigue. In addition, VRNT was associated with modest increases in functional connectivity of the somatomotor and default mode networks and decreased white matter fractional anisotropy in the corpus callosum adjacent to anterior cingula, relative to the control condition. This, VRNT showed preliminary efficacy in significantly reducing pain and improving overall functioning, possibly via changes in somatosensory and prefrontal brain networks.
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Mei Y, Wang W, Qiu D, Yuan Z, Bai X, Tang H, Zhang P, Zhang X, Zhang Y, Yu X, Sui B, Wang Y. Micro-structural white matter abnormalities in new daily persistent headache: a DTI study using TBSS analysis. J Headache Pain 2023; 24:80. [PMID: 37394419 DOI: 10.1186/s10194-023-01620-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND New daily persistent headache (NDPH) is a rare primary headache disorder characterized by daily and persistent sudden onset headaches. The pathogenesis of NDPH remains unclear, and there are few white matter imaging studies related to NDPH. The purpose of this study was to investigate the micro-structural abnormalities of white matter in NDPH and provided insights into the pathogenesis of this disease based on tract-based spatial statistics (TBSS). METHODS Twenty-one patients with NDPH and 25 healthy controls (HCs) were included in this study. T1 structural and diffusion magnetic resonance imaging (MRI) were acquired from all participants. Differences in the fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) between patients with NDPH and HCs were investigated using TBSS analysis. RESULTS Significantly decreased FA, increased MD and RD were found in patients with NDPH compared to HCs. White matter regions overlaid with decreased FA, increased MD and RD were found in 16 white matter tracts from the Johns Hopkins University ICBM-DTI-81 White-Matter Atlas and Johns Hopkins University White-Matter Tractography Atlas. Specifically, these white matter regions included the right anterior thalamic radiation (ATR), body of the corpus callosum (BCC), bilateral cingulum, left hippocampal cingulum (CGH), left corticospinal tract (CST), forceps major, fornix, left inferior fronto-occipital fasciculus (IFOF), bilateral inferior longitudinal fasciculus (ILF), left posterior limb of the internal capsule (PLIC), right retrolenticular part of the internal capsule (RPIC), splenium of the corpus callosum (SCC), right superior longitudinal fasciculus (SLF) and left uncinate fasciculus (UF). After Bonferroni correction, there were no correlations between the FA, MD, AD and RD values and the clinical characteristics of patients with NDPH (p > 0.05/96). CONCLUSION The results of our research indicated that patients with NDPH might have widespread abnormalities in the white matter of the brain.
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Affiliation(s)
- Yanliang Mei
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Wei Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Dong Qiu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Ziyu Yuan
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xiaoyan Bai
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Neurosurgical Institute, Beijing, China
| | - Hefei Tang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Peng Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xue Zhang
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, Neurosurgical Institute, Beijing, China
| | - Yaqing Zhang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Xueying Yu
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
| | - Binbin Sui
- Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
| | - Yonggang Wang
- Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
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Hsu PS, Cheng CM, Chao HT, Lin MW, Li WC, Lee LC, Liu CH, Chen LF, Hsieh JC. OPRM1 A118G polymorphism modulating motor pathway for pain adaptability in women with primary dysmenorrhea. Front Neurosci 2023; 17:1179851. [PMID: 37378013 PMCID: PMC10291086 DOI: 10.3389/fnins.2023.1179851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
Introduction Primary dysmenorrhea (PDM) is a common condition among women of reproductive age, characterized by menstrual pain in the absence of any organic causes. Previous research has established a link between the A118G polymorphism in the mu-opioid receptor (OPRM1) gene and pain experience in PDM. Specifically, carriers of the G allele have been found to exhibit maladaptive functional connectivity between the descending pain modulatory system and the motor system in young women with PDM. This study aims to explore the potential relationship between the OPRM1 A118G polymorphism and changes in white matter in young women with PDM. Methods The study enrolled 43 individuals with PDM, including 13 AA homozygotes and 30 G allele carriers. Diffusion tensor imaging (DTI) scans were performed during both the menstrual and peri-ovulatory phases, and tract-based spatial statistics (TBSS) and probabilistic tractography were used to explore variations in white matter microstructure related to the OPRM1 A118G polymorphism. The short-form McGill Pain Questionnaire (MPQ) was used to access participants' pain experience during the MEN phase. Results Two-way ANOVA on TBSS analysis revealed a significant main effect of genotype, with no phase effect or phase-gene interaction detected. Planned contrast analysis showed that during the menstrual phase, G allele carriers had higher fractional anisotropy (FA) and lower radial diffusivity in the corpus callosum and the left corona radiata compared to AA homozygotes. Tractographic analysis indicated the involvement of the left internal capsule, left corticospinal tract, and bilateral medial motor cortex. Additionally, the mean FA of the corpus callosum and the corona radiata was negatively correlated with MPQ scales in AA homozygotes, but this correlation was not observed in G allele carriers. No significant genotype difference was found during the pain-free peri-ovulary phase. Discussion OPRM1 A118G polymorphism may influence the connection between structural integrity and dysmenorrheic pain, where the G allele could impede the pain-regulating effects of the A allele. These novel findings shed light on the underlying mechanisms of both adaptive and maladaptive structural neuroplasticity in PDM, depending on the specific OPRM1 polymorphism.
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Affiliation(s)
- Pei-Shan Hsu
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Chou-Ming Cheng
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiang-Tai Chao
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Wei Lin
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Chi Li
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Biological Science and Technology, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Lin-Chien Lee
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Ching-Hsiung Liu
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Neurology, Lotung Poh-Ai Hospital, Yilan, Taiwan
| | - Li-Fen Chen
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Biomedical Informatics, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jen-Chuen Hsieh
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Biological Science and Technology, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-devices, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
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Mosch B, Hagena V, Herpertz S, Diers M. Brain morphometric changes in fibromyalgia and the impact of psychometric and clinical factors: a volumetric and diffusion-tensor imaging study. Arthritis Res Ther 2023; 25:81. [PMID: 37208755 DOI: 10.1186/s13075-023-03064-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/07/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Previous studies have repeatedly found distinct brain morphometric changes in patients with fibromyalgia (FM), mainly affecting gray and white matter abnormalities in areas related to sensory and affective pain processing. However, few studies have thus far linked different types of structural changes and not much is known about behavioral and clinical determinants that might influence the emergence and progression of such changes. METHODS We used voxel-based morphometry (VBM) and diffusion-tensor imaging (DTI) to detect regional patterns of (micro)structural gray (GM) and white matter (WM) alterations in 23 patients with FM compared to 21 healthy controls (HC), while considering the influence of demographic, psychometric, and clinical variables (age, symptom severity, pain duration, heat pain threshold, depression scores). RESULTS VBM and DTI revealed striking patterns of brain morphometric changes in FM patients. Bilateral middle temporal gyrus (MTG), parahippocampal gyrus, left dorsal anterior cingulate cortex (dACC), right putamen, right caudate nucleus, and left dorsolateral prefrontal cortex (DLPFC) showed significantly decreased GM volumes. In contrast, increased GM volume was observed in bilateral cerebellum and left thalamus. Beyond that, patients displayed microstructural changes of WM connectivity within the medial lemniscus, corpus callosum, and tracts surrounding and connecting the thalamus. Sensory-discriminative aspects of pain (pain severity, pain thresholds) primarily showed negative correlations with GM within bilateral putamen, pallidum, right midcingulate cortex (MCC), and multiple thalamic substructures, whereas the chronicity of pain was negatively correlated with GM volumes within right insular cortex and left rolandic operculum. Affective-motivational aspects of pain (depressive mood, general activity) were related to GM and FA values within bilateral putamen and thalamus. CONCLUSIONS Our results suggest a variety of distinct structural brain changes in FM, particularly affecting areas involved in pain and emotion processing such as the thalamus, putamen, and insula.
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Affiliation(s)
- Benjamin Mosch
- Clinical and Experimental Behavioral Medicine, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| | - Verena Hagena
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| | - Martin Diers
- Clinical and Experimental Behavioral Medicine, Alexandrinenstraße 1-3, 44791, Bochum, Germany.
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Tantik Pak A, Nacar Dogan S, Sengul Y. Structural integrity of corpus callosum in patients with migraine: a diffusion tensor imaging study. Acta Neurol Belg 2023; 123:385-390. [PMID: 35303287 DOI: 10.1007/s13760-021-01863-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/27/2021] [Indexed: 12/20/2022]
Abstract
The aim of this study was to compare structural changes of corpus callosum (CC), which is the largest collection of white matter in the brain, among migraineurs and healthy controls (HC). Diffusion tensor imaging (DTI) method which provides information about microscopic organization of the cell, especially white matter was used for this purpose. Fifty-one patients who were diagnosed with migraine and 44 age- and sex-matched HC were included in the study. Socio-demographic and clinical characteristics of the patients were noted. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) measurements of CC genu, splenium, and body were performed for all participants. A significant difference was determined between migraine patients and HC regarding the FA values in the genu of CC (p < 0.001). When the clinical data of migraine patients and FA values in the genu of CC were analyzed via linear regression analysis, no significant finding was detected (p > 0.05). In conclusion, it can be suggested that there are microstructural changes in the CC of migraneurs; however, the clinical variable associated with this structural deterioration could not be determined.
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Affiliation(s)
- Aygul Tantik Pak
- Department of Neurology, University of Ministry Health, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey.
| | - Sebahat Nacar Dogan
- Depertmant of Radiology, University of Ministry Health, Gaziosmanpasa Training and Research Hospital, Karayollari, Osmanbey Street 621, 34255, Gaziosmanpasa, Istanbul, Turkey
| | - Yildizhan Sengul
- Department of Neurology, University of Ministry Health, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey
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10
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Robertson JW, Aristi G, Hashmi JA. White matter microstructure predicts measures of clinical symptoms in chronic back pain patients. Neuroimage Clin 2023; 37:103309. [PMID: 36621020 PMCID: PMC9850203 DOI: 10.1016/j.nicl.2022.103309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/30/2022] [Accepted: 12/26/2022] [Indexed: 12/28/2022]
Abstract
Chronic back pain (CBP) has extensive clinical and social implications for its sufferers and is a major source of disability. Chronic pain has previously been shown to have central neural factors underpinning it, including the loss of white matter (WM), however traditional methods of analyzing WM microstructure have produced mixed and unclear results. To better understand these factors, we assessed the WM microstructure of 50 patients and 40 healthy controls (HC) using diffusion-weighted imaging. The data were analyzed using fixel-based analysis (FBA), a higher-order diffusion modelling technique applied to CBP for the first time here. Subjects also answered questionnaires relating to pain, disability, catastrophizing, and mood disorders, to establish the relationship between fixelwise metrics and clinical symptoms. FBA determined that, compared to HC, CBP patients had: 1) lower fibre density (FD) in several tracts, specifically the right anterior and bilateral superior thalamic radiations, right spinothalamic tract, right middle cerebellar peduncle, and the body and splenium of corpus callosum; 2) higher FD in the genu of corpus callosum; and 3) lower FDC - a combined fibre density and cross-section measure - in the bilateral spinothalamic tracts and right anterior thalamic radiation. Exploratory correlations showed strong negative relationships between fixelwise metrics and clinical questionnaire scores, especially pain catastrophizing. These results have important implications for the intake and processing of sensory data in CBP that warrant further investigation.
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Affiliation(s)
- Jason W Robertson
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, 1276 South Park St., Halifax, Nova Scotia B3H 2Y9, Canada; Nova Scotia Health Authority, 1276 South Park St., Halifax, Nova Scotia B3H 2Y9, Canada.
| | - Guillermo Aristi
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, 1276 South Park St., Halifax, Nova Scotia B3H 2Y9, Canada; Nova Scotia Health Authority, 1276 South Park St., Halifax, Nova Scotia B3H 2Y9, Canada
| | - Javeria A Hashmi
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, 1276 South Park St., Halifax, Nova Scotia B3H 2Y9, Canada; Nova Scotia Health Authority, 1276 South Park St., Halifax, Nova Scotia B3H 2Y9, Canada.
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11
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Zhang K, Wu C, Lyu Y, Xiang J, Pan C, Guo X, Tong S. Upper-limb amputation disrupts the interhemispheric structural rather than functional connectivity. Brain Connect 2022; 13:133-142. [PMID: 36082989 DOI: 10.1089/brain.2022.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Recent neuroimaging studies on upper-limb amputation have revealed the reorganization of bilateral sensorimotor cortex after sensory deprivation, underpinning the assumption of changes in the interhemispheric connections. In the present study, using functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), we aim to explore the alterations in the interhemispheric functional and structural connectivity after upper-limb amputation. Methods: Twenty-two upper-limb amputees and 15 age- and sex-matched healthy controls were recruited for MRI scanning. The amputees were further divided into subgroups by amputation side and residual limb pain (RLP). DTI metrics of corpus callosum (CC) subregions and resting-state functional connectivity (FC) between the bilateral sensorimotor cortices were measured for each participant. Linear mixed models were carried out to investigate the relationship of interhemispheric connectivity with the amputation, amputation side, and RLP. Results: Compared with healthy controls, upper-limb amputees showed lower axial diffusivity (AD) in CC subregions II and III. Subgroup analyses showed that the dominant hand amputation induced significant microstructural changes in CC subregion III. In addition, only amputees with RLP showed decreased fractional anisotropy and AD in CC, which was also correlated with the intensity of RLP. No significant changes in interhemispheric FC were found after upper-limb amputation. Conclusion: The present study demonstrated that the interhemispheric structural connectivity rather than FC degenerated after upper-limb amputation, and the degeneration of interhemispheric structural connectivity was shown to be relevant to the amputation side and the intensity of RLP. Impact statement Neuroimaging studies have revealed the functional reorganization of bilateral sensorimotor cortex after amputation, with expanded activation from the intact hemisphere to the deprived hemisphere. Our findings indicated a degeneration of interhemispheric white matter connections in upper-limb amputees, unveiling the underlying structural basis for bilateral functional reorganization after amputation.
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Affiliation(s)
- Kexu Zhang
- Shanghai Jiao Tong University, School of Biomedical Engineering, Shanghai Jiao Tong University, Jiangchuan Road, Shanghai, 200240, China, Shanghai, China, 200240
| | - Chaowei Wu
- Shanghai Jiao Tong University, School of Biomedical Engineering, Shanghai, China
| | - Yuanyuan Lyu
- Shanghai Jiao Tong University, School of Biomedical Engineering, Shanghai, China
| | - Jianbo Xiang
- The 2nd People’s Hospital of Changzhou of Nanjing Medical University, the Department of Radiology, Changzhou, China,
| | - Changjie Pan
- The 2nd People’s Hospital of Changzhou of Nanjing Medical University, the Department of Radiology, Changzhou, China
| | - Xiaoli Guo
- Shanghai Jiao Tong University, School of Biomedical Engineering, Shanghai, China
| | - Shanbao Tong
- Shanghai Jiao Tong University, School of Biomedical Engineering, Shanghai, China
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12
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Aster HC, Evdokimov D, Braun A, Üçeyler N, Kampf T, Pham M, Homola GA, Sommer C. CNS imaging characteristics in fibromyalgia patients with and without peripheral nerve involvement. Sci Rep 2022; 12:6707. [PMID: 35469050 PMCID: PMC9038916 DOI: 10.1038/s41598-022-10489-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 04/01/2022] [Indexed: 12/13/2022] Open
Abstract
We tested the hypothesis that reduced skin innervation in fibromyalgia syndrome is associated with specific CNS changes. This prospective case–control study included 43 women diagnosed with fibromyalgia syndrome and 40 healthy controls. We further compared the fibromyalgia subgroups with reduced (n = 21) and normal (n = 22) skin innervation. Brains were analysed for cortical volume, for white matter integrity, and for functional connectivity. Compared to controls, cortical thickness was decreased in regions of the frontal, temporal and parietal cortex in the fibromyalgia group as a whole, and decreased in the bilateral pericalcarine cortices in the fibromyalgia subgroup with reduced skin innervation. Diffusion tensor imaging revealed a significant increase in fractional anisotropy in the corona radiata, the corpus callosum, cingulum and fornix in patients with fibromyalgia compared to healthy controls and decreased FA in parts of the internal capsule and thalamic radiation in the subgroup with reduced skin innervation. Using resting-state fMRI, the fibromyalgia group as a whole showed functional hypoconnectivity between the right midfrontal gyrus and the posterior cerebellum and the right crus cerebellum, respectively. The subgroup with reduced skin innervation showed hyperconnectivity between the inferior frontal gyrus, the angular gyrus and the posterior parietal gyrus. Our results suggest that the subgroup of fibromyalgia patients with pronounced pathology in the peripheral nervous system shows alterations in morphology, structural and functional connectivity also at the level of the encephalon. We propose considering these subgroups when conducting clinical trials.
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Affiliation(s)
- Hans-Christoph Aster
- Neurologische Klinik und Poliklinik, Universitätsklinikum, Josef-Schneider-Str. 11, 97080, Würzburg, Germany. .,Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Margarate-Höppel-Platz 1, 97080, Würzburg, Germany.
| | - Dimitar Evdokimov
- Neurologische Klinik und Poliklinik, Universitätsklinikum, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Alexandra Braun
- Neurologische Klinik und Poliklinik, Universitätsklinikum, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Nurcan Üçeyler
- Neurologische Klinik und Poliklinik, Universitätsklinikum, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Thomas Kampf
- Institut für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum, Würzburg, Germany
| | - Mirko Pham
- Institut für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum, Würzburg, Germany
| | - György A Homola
- Institut für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum, Würzburg, Germany
| | - Claudia Sommer
- Neurologische Klinik und Poliklinik, Universitätsklinikum, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
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13
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Cheng S, Dong X, Zhou J, Tang C, He W, Chen Y, Zhang X, Ma P, Yin T, Hu Y, Zeng F, Li Z, Liang F. Alterations of the White Matter in Patients With Knee Osteoarthritis: A Diffusion Tensor Imaging Study With Tract-Based Spatial Statistics. Front Neurol 2022; 13:835050. [PMID: 35370891 PMCID: PMC8968011 DOI: 10.3389/fneur.2022.835050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/24/2022] [Indexed: 11/22/2022] Open
Abstract
Background Functional and structural alterations in the gray matter have been observed in patients with knee osteoarthritis (KOA). However, little is known about white matter changes in KOA. Here, we evaluated fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) to investigate potential alterations in the white matter of patients with KOA. Methods A total of 166 patients with KOA, along with 88 age- and sex-matched healthy controls were recruited and underwent brain magnetic resonance imaging (MRI). Diffusion tensor imaging (DTI) data were collected and analyzed using tract-based spatial statistics (TBSS). Statistical significances were determined at p < 0.05 and were corrected by the threshold-free cluster enhancement (TFCE) method. Then, we evaluated potential correlations between FA, MD, AD, RD values and disease duration, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and visual analog scale (VAS) scores. Results FA values for the body of corpus callosum, splenium of corpus callosum, bilateral superior longitudinal fasciculus, cingulum, bilateral superior corona radiata, and right posterior corona radiata were significantly higher in patients with KOA than in healthy controls (p < 0.05, TFCE corrected). Compared with healthy controls, patients with KOA also had significantly lower MD, AD, and RD values of the genu of corpus callosum, body of corpus callosum, splenium of corpus callosum, corona radiata, right posterior thalamic radiation, superior longitudinal fasciculus, and middle cerebellar peduncle (p < 0.05, TFCE corrected). Negative correlations were detected between WOMAC scores and AD values for the body of the corpus callosum and the splenium of the corpus callosum (p < 0.05, FDR corrected). Conclusion Patients with KOA exhibited extensive white matter alterations in sensorimotor and pain-related regions. Longitudinal observation studies on the causation between abnormalities in the white matter tracts and KOA is needed in the future.
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Affiliation(s)
- Shirui Cheng
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaohui Dong
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jun Zhou
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chenjian Tang
- The First Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wenhua He
- The Second Affiliated Hospital of Shanxi, University of Traditional Chinese Medicine, Taiyuan, China
| | - Yang Chen
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xinyue Zhang
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Peihong Ma
- Acupuncture and Moxibustion Department, Beijing University of Chinese Medicine, Beijing, China
| | - Tao Yin
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yimei Hu
- Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fang Zeng
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhengjie Li
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Zhengjie Li
| | - Fanrong Liang
- The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Fanrong Liang
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14
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Cay M, Gonzalez-Heydrich J, Teicher MH, van der Heijden H, Ongur D, Shinn AK, Upadhyay J. Childhood maltreatment and its role in the development of pain and psychopathology. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:195-206. [PMID: 35093193 PMCID: PMC10364973 DOI: 10.1016/s2352-4642(21)00339-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 06/14/2023]
Abstract
Childhood maltreatment represents a form of trauma capable of altering fundamental neurobiological properties and negatively impacting neurodevelopmental processes. An outcome of childhood maltreatment is the emergence of psychopathology, which might become evident during childhood or adolescence, but might also project into adulthood. In this Review, we propose a biobehavioural framework in which childhood maltreatment and the associated aberrant neurobiological mechanisms and behavioural processes additionally lead to the onset of altered pain processing and, ultimately, the existence of pain syndromes. Considering that subpopulations of maltreated children show preserved function and minimal psychiatric or pain symptoms, compensatory mechanisms-perhaps instilled by robust psychosocial support systems-are also discussed. We present validated tools and experimental methods that could facilitate better comprehension of the interactions between childhood maltreatment, psychopathology, and pain. Such tools and approaches can in parallel be implemented to monitor abnormal pain-related processes and potentially guide early intervention strategies in cases of childhood maltreatment.
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Affiliation(s)
- Mariesa Cay
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | | | - Martin H Teicher
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA; Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA
| | - Hanne van der Heijden
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Faculty of Science, Biomedical Sciences Neurobiology, University of Amsterdam, Amsterdam, Netherlands
| | - Dost Ongur
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA; Schizophrenia and Bipolar Disorder Program, Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
| | - Ann K Shinn
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA; Schizophrenia and Bipolar Disorder Program, Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
| | - Jaymin Upadhyay
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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15
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Kim DJ, Lim M, Kim JS, Chung CK. Structural and functional thalamocortical connectivity study in female fibromyalgia. Sci Rep 2021; 11:23323. [PMID: 34857797 PMCID: PMC8640058 DOI: 10.1038/s41598-021-02616-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/08/2021] [Indexed: 12/21/2022] Open
Abstract
Dysfunctional thalamocortical interactions have been suggested as putative mechanisms of ineffective pain modulation and also suggested as possible pathophysiology of fibromyalgia (FM). However, it remains unclear which specific thalamocortical networks are altered and whether it is related to abnormal pain perception in people with FM. Here, we conducted combined vertex-wise subcortical shape, cortical thickness, structural covariance, and resting-state functional connectivity analyses to address these questions. FM group exhibited a regional shape deflation of the left posterior thalamus encompassing the ventral posterior lateral and pulvinar nuclei. The structural covariance analysis showed that the extent of regional deflation of the left posterior thalamus was negatively covaried with the left inferior parietal cortical thickness in the FM group, whereas those two regions were positively covaried in the healthy controls. In functional connectivity analysis with the left posterior thalamus as a seed, FM group had less connectivity with the periaqueductal gray compared with healthy controls, but enhanced connectivity between the posterior thalamus and bilateral inferior parietal regions, associated with a lower electrical pain threshold at the hand dorsum (pain-free point). Overall, our findings showed the structural thalamic alteration interacts with the cortical regions in a functionally maladaptive direction, leading the FM brain more responsive to external stimuli and potentially contributing to pain amplification.
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Affiliation(s)
- Dajung J Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, 08826, Republic of Korea.,Department of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA
| | - Manyoel Lim
- Neuroscience Research Institute, Seoul National University College of Medicine, Seoul, 08826, Republic of Korea.,Department of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, 48109, USA
| | - June Sic Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, 08826, Republic of Korea.,Research Institute of Basic Sciences, Seoul National University, Seoul, 08826, Republic of Korea
| | - Chun Kee Chung
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, 08826, Republic of Korea. .,Department of Neurosurgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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16
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Cruz-Almeida Y, Coombes S, Febo M. Pain differences in neurite orientation dispersion and density imaging measures among community-dwelling older adults. Exp Gerontol 2021; 154:111520. [PMID: 34418483 DOI: 10.1016/j.exger.2021.111520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/07/2021] [Accepted: 08/13/2021] [Indexed: 01/29/2023]
Abstract
Neurite orientation dispersion and density imaging (NODDI) is a technique providing more detailed information on the microstructural bases of white matter. Given the previously reported white matter contributions to chronic pain, the present study aims to investigate pain-specific differences in NODDI measures across white matter tracts in a sample of community-dwelling older adults with (n = 29) and without (n = 18) chronic musculoskeletal pain. We further aimed to investigate associations between NODDI measures and clinical and experimental pain measures. As part of the Nepal study, a subset of older adults (>60 years old), underwent multiple laboratory sessions providing self-reported and experimental pain measures and a diffusion weighted neuroimaging sequence. Older adults with chronic musculoskeletal pain had a lower neurite density with less geometric complexity across a number of white matter tracts compared to older pain-free controls (corrected p's < 0.05). Lower neurite density was associated with greater self-reported pain intensity and anatomical pain sites, as well as greater experimental pain sensitivity (p's < 0.05). There were also significant pain-by-sex differences in neurite density and geometric complexity across multiple white matter tracts mainly around the hippocampus (corrected p's < 0.05). Finally, there were no pain differences with respect to extra-cellular water diffusion (corrected p's > 0.05). Our study demonstrates less geometric complexity in neurite density and architecture in chronic musculoskeletal pain, partly in a sex-dependent manner. An increased understanding of neurobiological mechanisms such as those measured by NODDI may contribute to the potential targeting of interventions in our older population suffering from chronic pain.
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Affiliation(s)
- Yenisel Cruz-Almeida
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, United States of America; Department of Community Dentistry & Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL, United States of America; Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States of America.
| | - Stephen Coombes
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, United States of America; Department of Applied Kinesiology & Physiology, College of Health & Human Performance, University of Florida, Gainesville, FL, United States of America
| | - Marcelo Febo
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, United States of America
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17
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Zhang J, Xu T, Wang L, Chen D, Gong L, Chen H, Yu J, Zhao L, Gao Q. Dynamic alterations of amplitude of low-frequency fluctuations in patients with chronic neck pain. PSYCHORADIOLOGY 2021; 1:110-117. [PMID: 38665806 PMCID: PMC10939338 DOI: 10.1093/psyrad/kkab011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 06/08/2021] [Accepted: 07/27/2021] [Indexed: 04/28/2024]
Abstract
Background The pathogenesis of neck pain in the brain, which is the fourth most common cause of disability, remains unclear. Furthermore, little is known about the characteristics of dynamic local functional brain activity in cervical pain. Objective The present study aimed to investigate the changes of local brain activity caused by chronic neck pain and the factors leading to neck pain. Methods Using the amplitude of low-frequency fluctuations (ALFF) method combined with sliding window approach, we compared local brain activity that was measured by the functional magnetic resonance imaging (fMRI) of 107 patients with chronic neck pain (CNP) with that of 57 healthy control participants. Five pathogenic factors were selected for correlation analysis. Results The group comparison results of dynamic amplitude of low-frequency fluctuation (dALFF) variability showed that patients with CNP exhibited decreased dALFF variability in the left inferior temporal gyrus, the middle temporal gyrus, the angular gyrus, the inferior parietal marginal angular gyrus, and the middle occipital gyrus. The abnormal dALFF variability of the left inferior temporal gyrus was negatively correlated with the average daily working hours of patients with neck pain. Conclusions The findings indicated that the brain regions of patients with CNP responsible for audition, vision, memory, and emotion were subjected to temporal variability of abnormal regional brain activity. Moreover, the dALFF variability in the left inferior temporal gyrus might be a risk factor for neck pain.This study revealed the brain dysfunction of patients with CNP from the perspective of dynamic local brain activity, and highlighted the important role of dALFF variability in understanding the neural mechanism of CNP.
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Affiliation(s)
- Jiabao Zhang
- School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Tao Xu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Linjia Wang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Dan Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Lisha Gong
- School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Huafu Chen
- Department of Radiology, First Affiliated Hospital to Army Medical University, Chongqing, 400038, China
- High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Jiali Yu
- School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Ling Zhao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
| | - Qing Gao
- School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, 611731, China
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18
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Li D, Xu H, Yang Q, Zhang M, Wang Y. Cerebral white matter alterations revealed by multiple diffusion metrics in cervical spondylotic patients with pain: A TBSS study. PAIN MEDICINE 2021; 23:895-901. [PMID: 34286334 DOI: 10.1093/pm/pnab227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The aims of the present study were to investigate white matter alterations and their associations with the clinical variables in cervical spondylotic (CS) patients with pain. DESIGN Cross-sectional study. SETTING Chinese community. SUBJECTS Forty-two CS patients with pain and 42 matched healthy participants were ultimately recruited from August 2018 to September 2019. METHODS Tract-based spatial statistics (TBSS) analysis was performed to investigate the differences of DTI-derived indices (fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD)) between the patients and healthy controls throughout brain white matter. The relationship of the severity of cervical pain and affective disturbance to aberrant DTI indices in the patients was also examined using spearman correlation analyses. RESULTS The CS patients with pain showed decreased FA in the genu, body, and splenium portions of corpus callosum (CC), and increased MD and RD along with decreased FA in anterior corona radiata (ACR) compared with healthy controls, whereas no significant difference of AD was observed between groups. Additionally, lower FA of the genu part of CC together with higher MD of the left ACR were statistically correlated with the pain severity in the patient group. CONCLUSIONS Decreased FA coupled with increased MD and RD was detected in multiple white matter regions, and several DTI metrics in certain white matter tracts had moderate relationships with the pain severity in the CS patients with pain. These observations may provide alternative imaging clues for the evaluation of the pathophysiological characteristics of CS pain.
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Affiliation(s)
- Dan Li
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi'an Jiaotong University
| | - Hui Xu
- Department of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University
| | - Qian Yang
- Department of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University
| | - Ming Zhang
- Department of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University
| | - Yuan Wang
- Department of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University
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19
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Sundermann B, Dehghan Nayyeri M, Pfleiderer B, Stahlberg K, Jünke L, Baie L, Dieckmann R, Liem D, Happe T, Burgmer M. Subtle changes of gray matter volume in fibromyalgia reflect chronic musculoskeletal pain rather than disease-specific effects. Eur J Neurosci 2019; 50:3958-3967. [PMID: 31448468 DOI: 10.1111/ejn.14558] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/01/2019] [Accepted: 08/08/2019] [Indexed: 12/17/2022]
Abstract
Fibromyalgia syndrome (FMS) is a chronic pain syndrome. Neuroimaging studies provided evidence of altered gray matter volume (GMV) in FMS but, similarly, in chronic pain of other origin as well. Therefore, the purpose of this study was to evaluate the disease specificity of GMV alterations in FMS by direct comparison. Structural MRI data of the brain were acquired in 25 females with FMS and two different control groups: 21 healthy subjects and 23 patients with osteoarthritis. Regional GMVs were compared by voxel-based morphometry and additional ROI-analyses. In conclusion, we did not identify significant GMV alterations in either FMS or OA patients compared to healthy controls when adopting a conservative statistical approach with multiple comparison correction. However, even under a more liberal approach no FMS-specific GMV changes were found because both pain groups presented increased gray matter volumes in the precentral gyrus and decreased GMV in the angular gyrus/middle occipital gyrus and middle temporal gyrus in comparison with healthy controls. Since no differences between both pain groups could be detected cortical GMV changes in FMS should not be interpreted as FMS-specific but might rather reflect changes in chronic pain in general. This previously held notion is confirmed in this study by direct comparison with a control group consisting of another pain disorder.
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Affiliation(s)
- Benedikt Sundermann
- Department of Clinical Radiology, Medical Faculty - University of Muenster - and University Hospital Muenster, Münster, Germany
| | - Mahboobeh Dehghan Nayyeri
- Department of Clinical Radiology, Medical Faculty - University of Muenster - and University Hospital Muenster, Münster, Germany.,Department of Psychosomatic Medicine and Psychotherapy, LVR Clinic, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Bettina Pfleiderer
- Department of Clinical Radiology, Medical Faculty - University of Muenster - and University Hospital Muenster, Münster, Germany
| | - Kim Stahlberg
- Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - Leonie Jünke
- Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - Lara Baie
- Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
| | - Ralf Dieckmann
- Department of General Orthopaedics and Tumororthopaedics, University Hospital Münster, Münster, Germany
| | - Dennis Liem
- Department of General Orthopaedics and Tumororthopaedics, University Hospital Münster, Münster, Germany
| | | | - Markus Burgmer
- Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany
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20
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Disrupted Resting State Network of Fibromyalgia in Theta frequency. Sci Rep 2018; 8:2064. [PMID: 29391478 PMCID: PMC5794911 DOI: 10.1038/s41598-017-18999-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 12/12/2017] [Indexed: 12/26/2022] Open
Abstract
Fibromyalgia (FM), chronic widespread pain, exhibits spontaneous pain without external stimuli and is associated with altered brain activities during resting state. To understand the topological features of brain network in FM, we employed persistent homology which is a multiple scale network modeling framework not requiring thresholding. Spontaneous magnetoencephalography (MEG) activity was recorded in 19 healthy controls (HCs) and 18 FM patients. Barcode, single linkage dendrogram and single linkage matrix were generated based on the proposed modeling framework. In theta band, the slope of decrease in the number of connected components in barcodes showed steeper in HC, suggesting FM patients had decreased global connectivity. FM patients had reduced connectivity within default mode network, between middle/inferior temporal gyrus and visual cortex. The longer pain duration was correlated with reduced connectivity between inferior temporal gyrus and visual cortex. Our findings demonstrated that the aberrant resting state network could be associated with dysfunction of sensory processing in chronic pain. The spontaneous nature of FM pain may accrue to disruption of resting state network.
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21
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Nan J, Zhang L, Chen Q, Zong N, Zhang P, Ji X, Ma S, Zhang Y, Huang W, Du Z, Xia Y, Zhang M. White Matter Microstructural Similarity and Diversity of Functional Constipation and Constipation-predominant Irritable Bowel Syndrome. J Neurogastroenterol Motil 2018; 24:107-118. [PMID: 29291612 PMCID: PMC5753909 DOI: 10.5056/jnm17038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/24/2017] [Accepted: 08/16/2017] [Indexed: 12/21/2022] Open
Abstract
Background/Aims The Rome III criteria separated chronic constipation into functional constipation (FC) and constipation-predominant irritable bowel syndrome (IBS-C), but some researchers questioned the partitioning and treated both as distinct parts of a continuum. The study aims to explore the similarity and diversity of brain white matter between FC and IBS-C. Methods The voxel-wise analysis of the diffusion parameters was used to quantify the white matter changes of female brains in 18 FC patients and 20 IBS-C patients compared with a comparison group with 19 healthy controls by tract-based spatial statistics. The correlations between diffusive parameters and clinical symptoms were evaluated using a Pearson's correlation. Results In comparison to healthy controls, FC patients showed a decrease of fractional anisotropy (FA) and an increase of radial diffusivity (RD) in multiple major fibers encompassing the corpus callosum (CC, P = 0.001 at peak), external capsule (P = 0.002 at peak), corona radiata (CR, P = 0.001 at peak), and superior longitudinal fasciculus (SLF, P = 0.002 at peak). In contrast, IBS-C patients showed FA and RD aberrations in the CC (P = 0.048 at peak). Moreover, the direct comparison between FC and IBS-C showed only RD differences in the CR and SLF. In addition, FA and RD in the CC were significantly associated with abdominal pain for all patients, whereas FA in CR (P = 0.016) and SLF (P = 0.040) were significantly associated with the length of time per attempt and incomplete evacuation separately for FC patients. Conclusion These results may improve our understanding of the pathophysiological mechanisms underlying different types of constipation.
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Affiliation(s)
- Jiaofen Nan
- School of Computer and Communication Engineering, Zhengzhou University of Light Industry, Zhengzhou, China
| | - Liangliang Zhang
- School of Computer and Communication Engineering, Zhengzhou University of Light Industry, Zhengzhou, China
| | - Qiqiang Chen
- School of Computer and Communication Engineering, Zhengzhou University of Light Industry, Zhengzhou, China
| | - Nannan Zong
- School of Computer and Communication Engineering, Zhengzhou University of Light Industry, Zhengzhou, China
| | - Peiyong Zhang
- First Affiliated Hospital of Xinxiang Medical University, Weihui, China
| | - Xing Ji
- First Affiliated Hospital of Yan'an University, Yan'an, China
| | - Shaohui Ma
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yuchen Zhang
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wei Huang
- School of Computer and Communication Engineering, Zhengzhou University of Light Industry, Zhengzhou, China
| | - Zhongzhou Du
- School of Computer and Communication Engineering, Zhengzhou University of Light Industry, Zhengzhou, China
| | - Yongquan Xia
- School of Computer and Communication Engineering, Zhengzhou University of Light Industry, Zhengzhou, China
| | - Ming Zhang
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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22
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Coppieters I, De Pauw R, Caeyenberghs K, Lenoir D, DeBlaere K, Genbrugge E, Meeus M, Cagnie B. Differences in white matter structure and cortical thickness between patients with traumatic and idiopathic chronic neck pain: Associations with cognition and pain modulation? Hum Brain Mapp 2018; 39:1721-1742. [PMID: 29327392 DOI: 10.1002/hbm.23947] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 12/05/2017] [Accepted: 01/01/2018] [Indexed: 12/18/2022] Open
Abstract
Brain alterations are hypothesized to be present in patients with chronic whiplash-associated disorders (CWAD). The aim of this case-control study was to examine alterations in cortical thickness and white matter (WM) structure, and the presence of brain microhemorrhages in a patient group encountering chronic neck pain of traumatic origin (i.e., CWAD) when compared with a patient group characterized by nontraumatic chronic neck pain [i.e., chronic idiopathic neck pain (CINP)], and healthy controls. Furthermore, we aimed to investigate associations between brain structure on one hand and cognitive performance and central sensitization (CS) on the other hand. T1-weighted, diffusion-weighted and T2*-weighted magnetic resonance images of the brain were acquired in 105 women (31 controls, 37 CINP, 37 CWAD) to investigate regional cortical thickness, WM structure, and microhemorrhages, respectively. Next, cognitive performance, and CS encompassing distant hyperalgesia and conditioned pain modulation (CPM) efficacy were examined. Cortical thinning in the left precuneus was revealed in CWAD compared with CINP patients. Also, decreased fractional anisotropy, together with increased values of mean diffusivity and radial diffusivity could be observed in the left cingulum hippocampus and tapetum in CWAD compared with CINP, and in the left tapetum in CWAD patients compared with controls. Moreover, the extent of WM structural deficits in the left tapetum coincided with decreased CPM efficacy in the CWAD group. This yields evidence for associations between decreased endogenous pain inhibition, and the degree of regional WM deficits in CWAD. Our results emphasize the role of structural brain alterations in women with CWAD compared with CINP.
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Affiliation(s)
- I Coppieters
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group (www.paininmotion.be).,Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium
| | - R De Pauw
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - K Caeyenberghs
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Banyo, Australia
| | - D Lenoir
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - K DeBlaere
- Department of Radiology, Ghent University, Ghent, Belgium
| | - E Genbrugge
- Department of Radiology, Ghent University, Ghent, Belgium
| | - M Meeus
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group (www.paininmotion.be).,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - B Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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23
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Long Y, Ouyang X, Liu Z, Chen X, Hu X, Lee E, Chen EYH, Pu W, Shan B, Rohrbaugh RM. Associations Among Suicidal Ideation, White Matter Integrity and Cognitive Deficit in First-Episode Schizophrenia. Front Psychiatry 2018; 9:391. [PMID: 30210372 PMCID: PMC6121174 DOI: 10.3389/fpsyt.2018.00391] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 08/03/2018] [Indexed: 11/26/2022] Open
Abstract
Objective: The study was aimed to investigate the possible associations among suicidal ideation, brain white matter (WM) integrity and cognitive deficit in first-episode schizophrenia (FES) using diffusion tensor imaging. Methods: The sample contained 18 FES patients with suicidal ideation (SI+), 45 FES patients without suicidal ideation (SI-) and 44 healthy controls. The Calgary Depression Scale for Schizophrenia was used to measure the suicidal ideation and depression symptoms. The whole brain WM integrity and three domains of cognitive function: working memory, verbal comprehension as well as processing speed were compared between the three groups. Results: Compared with SI-, SI+ showed preserved WM integrity as indicated by significantly higher factional anisotropy (FA) or lower mean diffusivity (MD) in multiple WM tracts, and higher FA coupled with lower MD in bilateral posterior corona radiata. Compared with SI-, SI+ were more depressed and had less cognitive deficit in working memory and verbal comprehension. The fiber tracts in bilateral posterior corona radiata connect to the precuneus as shown by probabilistic tractography, and their WM integrity disruptions were found to be positively associated with the cognitive deficits in the FES patients. Discussion: Preserved WM integrity may be a risk factor for suicidal ideation in FES patients. One possible explanation is that it contributes to preserved cognitive function, especially in working memory and verbal comprehension, which may be associated with greater insight and could lead to increased depression and suicidal ideation. The posterior corona radiata and the precuneus may be linked to the related biological processes.
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Affiliation(s)
- Yicheng Long
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xuan Ouyang
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Chinese National Clinical Research Center on Mental Health Disorders, National Technology Institute of Psychiatry, Changsha, China
| | - Zhening Liu
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China.,Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Chinese National Clinical Research Center on Mental Health Disorders, National Technology Institute of Psychiatry, Changsha, China
| | - Xudong Chen
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xinran Hu
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Edwin Lee
- Department of Psychiatry, University of Hong Kong, Hong Kong, Hong Kong
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong, Hong Kong.,State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, Hong Kong
| | - Weidan Pu
- Medical Psychological Center, Second Xiangya Hospital, Central South University, Changsha, China
| | - Baoci Shan
- Key Laboratory of Nuclear Analysis, Institute of High Energy Physics, Chinese Academy of Sciences, Beijing, China
| | - Robert M Rohrbaugh
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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24
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Cerebral white matter structure is disrupted in Gulf War Veterans with chronic musculoskeletal pain. Pain 2017; 158:2364-2375. [DOI: 10.1097/j.pain.0000000000001038] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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25
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Walitt B, Ceko M, Gracely JL, Gracely RH. Neuroimaging of Central Sensitivity Syndromes: Key Insights from the Scientific Literature. Curr Rheumatol Rev 2016; 12:55-87. [PMID: 26717948 DOI: 10.2174/1573397112666151231111104] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 06/24/2015] [Accepted: 12/29/2015] [Indexed: 12/14/2022]
Abstract
Central sensitivity syndromes are characterized by distressing symptoms, such as pain and fatigue, in the absence of clinically obvious pathology. The scientific underpinnings of these disorders are not currently known. Modern neuroimaging techniques promise new insights into mechanisms mediating these postulated syndromes. We review the results of neuroimaging applied to five central sensitivity syndromes: fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, temporomandibular joint disorder, and vulvodynia syndrome. Neuroimaging studies of basal metabolism, anatomic constitution, molecular constituents, evoked neural activity, and treatment effect are compared across all of these syndromes. Evoked sensory paradigms reveal sensory augmentation to both painful and nonpainful stimulation. This is a transformative observation for these syndromes, which were historically considered to be completely of hysterical or feigned in origin. However, whether sensory augmentation represents the cause of these syndromes, a predisposing factor, an endophenotype, or an epiphenomenon cannot be discerned from the current literature. Further, the result from cross-sectional neuroimaging studies of basal activity, anatomy, and molecular constituency are extremely heterogeneous within and between the syndromes. A defining neuroimaging "signature" cannot be discerned for any of the particular syndromes or for an over-arching central sensitization mechanism common to all of the syndromes. Several issues confound initial attempts to meaningfully measure treatment effects in these syndromes. At this time, the existence of "central sensitivity syndromes" is based more soundly on clinical and epidemiological evidence. A coherent picture of a "central sensitization" mechanism that bridges across all of these syndromes does not emerge from the existing scientific evidence.
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Affiliation(s)
- Brian Walitt
- National Center for Complementary and Integrative Health, National Institutes of Health, 10 Center Drive, Bethesda, MD 20814, USA.
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26
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Coppieters I, Meeus M, Kregel J, Caeyenberghs K, De Pauw R, Goubert D, Cagnie B. Relations Between Brain Alterations and Clinical Pain Measures in Chronic Musculoskeletal Pain: A Systematic Review. THE JOURNAL OF PAIN 2016; 17:949-62. [DOI: 10.1016/j.jpain.2016.04.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/11/2016] [Accepted: 04/18/2016] [Indexed: 10/21/2022]
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27
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Liu P, Wang G, Liu Y, Yu Q, Yang F, Jin L, Sun J, Yang X, Qin W, Calhoun VD. White matter microstructure alterations in primary dysmenorrhea assessed by diffusion tensor imaging. Sci Rep 2016; 6:25836. [PMID: 27161845 PMCID: PMC4861968 DOI: 10.1038/srep25836] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 04/22/2016] [Indexed: 11/12/2022] Open
Abstract
Primary dysmenorrhea (PDM), a significant public health problem for adolescents and young women, is characterized by painful menstrual cramps. Recent neuroimaging studies have revealed that brain functional and structural abnormalities are related to the pathomechanism of PDM. However, it is not clear whether there are white matter (WM) alterations in PDM. We analyzed diffusion tensor imaging data from 35 patients and 35 healthy controls (HCs) matched for age and handedness. Tract-based spatial statistics and probabilistic tractography were used to measure integrity of WM microstructure. Compared to HCs, patients had increased fractional anisotropy (FA) along with decreased mean diffusivity (MD) and radial diffusivity (RD) in the corpus callosum (CC), superior longitudinal fasciculus (LF), corona radiata (CR), internal capsule (IC) and external capsule (EC). The FA of the splenium CC and right IC positively correlated with PDM duration while FA of the right anterior CR positively correlated with PDM severity in patient group. These WM tracts were found to show connections to other brain regions implicated in sensoimotor, affective, cognitive and pain processing functions through tractography. These findings provide preliminary evidence for WM microstructure alterations in PDM, which is potentially valuable for understanding pathomechanism of PDM.
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Affiliation(s)
- Peng Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Geliang Wang
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Yanfei Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Qingbao Yu
- The Mind Research Network, Albuquerque, New Mexico 87106, USA
| | - Fan Yang
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Lingmin Jin
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Jinbo Sun
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Xuejuan Yang
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Wei Qin
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an 710071, China
| | - Vince D Calhoun
- The Mind Research Network, Albuquerque, New Mexico 87106, USA.,Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, New Mexico 87131, USA
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28
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Augmented Pain Processing in Primary and Secondary Somatosensory Cortex in Fibromyalgia: A Magnetoencephalography Study Using Intra-Epidermal Electrical Stimulation. PLoS One 2016; 11:e0151776. [PMID: 26992095 PMCID: PMC4798786 DOI: 10.1371/journal.pone.0151776] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 03/03/2016] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to investigate augmented pain processing in the cortical somatosensory system in patients with fibromyalgia (FM). Cortical evoked responses were recorded in FM (n = 19) and healthy subjects (n = 21) using magnetoencephalography after noxious intra-epidermal electrical stimulation (IES) of the hand dorsum (pain rating 6 on a numeric rating scale, perceptually-equivalent). In addition, healthy subjects were stimulated using the amplitude corresponding to the average stimulus intensity rated 6 in patients with FM (intensity-equivalent). Quantitative sensory testing was performed on the hand dorsum or thenar muscle (neutral site) and over the trapezius muscle (tender point), using IES (thresholds, ratings, temporal summation of pain, stimulus-response curve) and mechanical stimuli (threshold, ratings). Increased amplitude of cortical responses was found in patients with FM as compared to healthy subjects. These included the contralateral primary (S1) and bilateral secondary somatosensory cortices (S2) in response to intensity-equivalent stimuli and the contralateral S1 and S2 in response to perceptually-equivalent stimuli. The amplitude of the contralateral S2 response in patients with FM was positively correlated with average pain intensity over the last week. Quantitative sensory testing results showed that patients with FM were more sensitive to painful IES as well as to mechanical stimulation, regardless of whether the stimulation site was the hand or the trapezius muscle. Interestingly, the slope of the stimulus-response relationship as well as temporal summation of pain in response to IES was not different between groups. Together, these results suggest that the observed pain augmentation in response to IES in patients with FM could be due to sensitization or disinhibition of the cortical somatosensory system. Since the S2 has been shown to play a role in higher-order functions, further studies are needed to clarify the role of augmented S2 response in clinical characteristics of FM.
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29
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Lim M, Kim JS, Kim DJ, Chung CK. Increased Low- and High-Frequency Oscillatory Activity in the Prefrontal Cortex of Fibromyalgia Patients. Front Hum Neurosci 2016; 10:111. [PMID: 27014041 PMCID: PMC4789463 DOI: 10.3389/fnhum.2016.00111] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 02/29/2016] [Indexed: 11/30/2022] Open
Abstract
Recent human neuroimaging studies have suggested that fibromyalgia (FM), a chronic widespread pain disorder, exhibits altered thalamic structure and function. Since the thalamus has extensive reciprocal connection with the cortex, structural and functional thalamic alterations in FM might be linked to aberrant thalamocortical oscillation. This study investigated the presence of abnormal brain rhythmicity in low- and high-frequency bands during resting state in patients with FM and their relationship to clinical pain symptom. Spontaneous magnetoencephalography (MEG) activity was recorded in 18 females with FM and 18 age- and sex-matched healthy control (HC) subjects. The most remarkable finding was that FM patients had general increases in theta, beta and gamma power along with a slowing of the dominant alpha peak. Increased spectral powers in the theta-band were primarily localized to the left dorsolateral prefrontal (DLPFC) and orbitofrontal cortex (OFC). Beta and gamma over-activation were localized to insular, primary motor and primary and secondary somatosensory (S2) cortices, as well as the DLPFC and OFC. Furthermore, enhanced high-frequency oscillatory activities in the DLPFC and OFC were associated with higher affective pain scores in patients with FM. Our results demonstrate that FM patients feature enhanced low- and high-frequency oscillatory activity in the brain areas related to cognitive and emotional modulation of pain. Increased low- and high-frequency activity of the prefrontal cortex may contribute to persistent perception of pain in FM. Therapeutic intervention based on manipulating neural oscillation to restore normal thalamocortical rhythmicity may be beneficial to pain relief in FM.
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Affiliation(s)
- Manyoel Lim
- Neuroscience Research Institute, Seoul National University College of Medicine Seoul, South Korea
| | - June Sic Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences Seoul, South Korea
| | - Dajung J Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences Seoul, South Korea
| | - Chun Kee Chung
- Neuroscience Research Institute, Seoul National University College of MedicineSeoul, South Korea; Department of Brain and Cognitive Sciences, Seoul National University College of Natural SciencesSeoul, South Korea; Department of Neurosurgery, Seoul National University HospitalSeoul, South Korea
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30
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Abstract
Fibromyalgia (FM) is a chronic widespread pain condition linked to central sensitization. Altered excitability of sensorimotor cortex has been proposed as an underlying pathology of FM. This study aimed to investigate intracortical excitability of the primary somatosensory cortex (S1) and its potential role in clinical pain in patients with FM. Somatosensory evoked magnetic fields were recorded in 17 right-handed females with FM and 21 age-, sex-, and handedness-matched healthy control subjects. Paired-pulse median nerve stimulation was delivered to the left and right wrist. We assessed the peak-to-peak amplitudes of the N20m-P35m and peak amplitude of each N20m and P35m component. Paired-pulse suppression (PPS) of the second response was quantified as the ratio of the amplitudes of the second to the first response. Patients with FM displayed significantly higher PPS ratio for the N20m-P35m in both hemispheres, indicating reduced intracortical inhibition in the S1. Notably, PPS ratio for the P35m was higher in patients with FM than in healthy controls, whereas no differences were apparent in PPS ratio for the N20m in both hemispheres. For both the N20m-P35m and the P35m in the left hemisphere, PPS ratios were positively associated with the sensory pain on the short-form McGill Pain Questionnaire. This study demonstrated that intracortical inhibition in the S1 is compromised bilaterally in patients with FM, and the extent of disinhibition can be closely associated with increased clinical pain. Our results suggest that changes of intracortical inhibition of the S1 may contribute to the pathophysiology of FM pain.
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