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Cheng S, Zeng F, Zhou J, Dong X, Yang W, Yin T, Huang K, Liang F, Li Z. Altered static and dynamic functional brain network in knee osteoarthritis: A resting-state functional magnetic resonance imaging study: Static and dynamic FNC in KOA. Neuroimage 2024; 292:120599. [PMID: 38608799 DOI: 10.1016/j.neuroimage.2024.120599] [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: 06/24/2023] [Revised: 03/26/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
This study aimed to investigate altered static and dynamic functional network connectivity (FNC) and its correlation with clinical symptoms in patients with knee osteoarthritis (KOA). One hundred and fifty-nine patients with KOA and 73 age- and gender-matched healthy subjects (HS) underwent resting-state functional magnetic resonance imaging (rs-fMRI) and clinical evaluations. Group independent component analysis (GICA) was applied, and seven resting-state networks were identified. Patients with KOA had decreased static FNC within the default mode network (DM), visual network (VS), and cerebellar network (CB) and increased static FNC between the subcortical network (SC) and VS (p < 0.05, FDR corrected). Four reoccurring FNC states were identified using k-means clustering analysis. Although abnormalities in dynamic FNCs of KOA patients have been found using the common window size (22 TR, 44 s), but the results of the clustering analysis were inconsistent when using different window sizes, suggesting dynamic FNCs might be an unstable method to compare brain function between KOA patients and HS. These recent findings illustrate that patients with KOA have a wide range of abnormalities in the static and dynamic FNCs, which provided a reference for the identification of potential central nervous therapeutic targets for KOA treatment and might shed light on the other musculoskeletal pain neuroimaging studies.
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Affiliation(s)
- Shirui Cheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; Key Laboratory of Acupuncture for Senile Disease (Chengdu University of TCM), Ministry of Education, Chengdu 611137, China
| | - Fang Zeng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; Key Laboratory of Acupuncture for Senile Disease (Chengdu University of TCM), Ministry of Education, Chengdu 611137, China
| | - Jun Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Xiaohui Dong
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Weihua Yang
- Dali Bai Autonomous Prefecture Chinese Medicine Hospital, Dali 671000, China
| | - Tao Yin
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; Key Laboratory of Acupuncture for Senile Disease (Chengdu University of TCM), Ministry of Education, Chengdu 611137, China
| | - Kama Huang
- College of Electronics and Information Engineering, Sichuan University, Chengdu 610064, China
| | - Fanrong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; Key Laboratory of Acupuncture for Senile Disease (Chengdu University of TCM), Ministry of Education, Chengdu 611137, China.
| | - Zhengjie Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China; Key Laboratory of Acupuncture for Senile Disease (Chengdu University of TCM), Ministry of Education, Chengdu 611137, China.
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McBenedict B, Petrus D, Pires MP, Pogodina A, Arrey Agbor DB, Ahmed YA, Castro Ceron JI, Balaji A, Abrahão A, Lima Pessôa B. The Role of the Insula in Chronic Pain and Associated Structural Changes: An Integrative Review. Cureus 2024; 16:e58511. [PMID: 38770492 PMCID: PMC11103916 DOI: 10.7759/cureus.58511] [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: 03/11/2024] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Chronic pain affects a substantial portion of the global population, significantly impacting quality of life and well-being. This condition involves complex mechanisms, including dysfunction of the autonomic nervous system, which plays a crucial role in pain perception. The insula, a key brain region involved in pain processing, plays a critical role in pain perception and modulation. Lesions in the insula can result in pain asymbolia, where pain perception remains intact but emotional responses are inappropriate. The insula is anatomically and functionally divided into anterior and posterior regions, with the posterior insula processing nociceptive input based on intensity and location before relaying it to the anterior insula for emotional mediation. Understanding the insula's intricate role in pain processing is crucial, as it is involved in encoding prediction errors and mediating emotional dimensions of pain perception. The focus of this review was on synthesizing existing literature on the role of the insula in chronic pain and associated structural changes. The goal was to integrate findings from various sources to provide a comprehensive overview of the topic. The search strategy included a combination of Medical Subject Headings (MeSH) and relevant keywords related to insula and chronic pain. The following databases were surveyed: PubMed, Embase, Scopus, and Web of Science. We identified a total of 2515 articles, and after following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline based on eligibility criteria, 46 articles were used to synthesize this review. Our study highlights the pivotal role of the insula in chronic pain processing and associated structural changes, integrating findings from diverse studies and neuroimaging investigations. Beyond mere pain sensation, the insula contributes to emotional awareness, attention, and salience detection within the pain network. Various chronic pain conditions reveal alterations in insular activity and connectivity, accompanied by changes in gray matter volume and neurochemical profiles. Interventions targeting the insula show promise in alleviating chronic pain symptoms. However, further research is needed to understand underlying mechanisms, which can aid in developing more effective therapeutic interventions for pain.
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Affiliation(s)
| | - Dulci Petrus
- Family Health, Directorate of Special Programs, Ministry of Health and Social Services, Windhoek, NAM
| | | | - Anna Pogodina
- Medicine and Surgery, University of Buckingham, Buckingham, GBR
| | | | - Yusuf A Ahmed
- Faculty of Medicine, Mansoura University, Mansoura, EGY
| | - Jose Ittay Castro Ceron
- Academic Medicine, Institute of Health Sciences, Autonomous University of the State of Hidalgo, Pachuca, MEX
| | - Aishwariya Balaji
- General Practice, Government Kilpauk Medical College and Hospital, Chennai, IND
| | - Ana Abrahão
- Public Health, Fluminense Federal University, Niterói, BRA
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Hall M, Dobson F, Klyne DM, Zheng CJ, Lima YL, Egorova-Brumley N. Neurobiology of osteoarthritis: a systematic review and activation likelihood estimation meta-analysis. Sci Rep 2023; 13:12442. [PMID: 37528135 PMCID: PMC10394087 DOI: 10.1038/s41598-023-39245-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/21/2023] [Indexed: 08/03/2023] Open
Abstract
Osteoarthritis (OA) affects 240 million people worldwide. Neuroimaging has been increasingly used to investigate brain changes in OA, however, there is considerable heterogeneity in reported results. The goal of this systematic review and meta-analysis was to synthesise existing literature and identify consistent brain alterations in OA. Six databases were searched from inception up to June, 2022. Full-texts of original human studies were included if they had: (i) neuroimaging data by site of OA (e.g. hand, knee, hip); (ii) data in healthy controls (HC); (iii) > 10 participants. Activation likelihood estimation (ALE) was conducted using GingerALE software on studies that reported peak activation coordinates and sample size. Our search strategy identified 6250 articles. Twenty-eight studies fulfilled the eligibility criteria, of which 18 were included in the meta-analysis. There were no significant differences in brain structure or function between OA and healthy control contrasts. In exploratory analysis, the right insula was associated with OA vs healthy controls, with less activity, connectivity and brain volume in OA. This region was implicated in both knee and hip OA, with an additional cluster in the medial prefrontal cortex observed only in the contrast between healthy controls and the hip OA subgroup, suggesting a possible distinction between the neural correlates of OA subtypes. Despite the limitations associated with heterogeneity and poor study quality, this synthesis identified neurobiological outcomes associated with OA, providing insight for future research. PROSPERO registration number: CRD42021238735.
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Affiliation(s)
- Michelle Hall
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
- Centre for Arthritis Research, School of Medicine, University College Dublin, Dublin, Ireland.
| | - Fiona Dobson
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - David Murray Klyne
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Carmen Jiamin Zheng
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Yuri Lopes Lima
- School of Health Science and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Natalia Egorova-Brumley
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia.
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From Low-Grade Inflammation in Osteoarthritis to Neuropsychiatric Sequelae: A Narrative Review. Int J Mol Sci 2022; 23:ijms232416031. [PMID: 36555670 PMCID: PMC9784931 DOI: 10.3390/ijms232416031] [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: 11/14/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Nowadays, osteoarthritis (OA), a common, multifactorial musculoskeletal disease, is considered to have a low-grade inflammatory pathogenetic component. Lately, neuropsychiatric sequelae of the disease have gained recognition. However, a link between the peripheral inflammatory process of OA and the development of neuropsychiatric pathology is not completely understood. In this review, we provide a narrative that explores the development of neuropsychiatric disease in the presence of chronic peripheral low-grade inflammation with a focus on its signaling to the brain. We describe the development of a pro-inflammatory environment in the OA-affected joint. We discuss inflammation-signaling pathways that link the affected joint to the central nervous system, mainly using primary sensory afferents and blood circulation via circumventricular organs and cerebral endothelium. The review describes molecular and cellular changes in the brain, recognized in the presence of chronic peripheral inflammation. In addition, changes in the volume of gray matter and alterations of connectivity important for the assessment of the efficacy of treatment in OA are discussed in the given review. Finally, the narrative considers the importance of the use of neuropsychiatric diagnostic tools for a disease with an inflammatory component in the clinical setting.
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Biological Targets of Multimolecular Therapies in Middle-Age Osteoarthritis. Sports Med Arthrosc Rev 2022; 30:141-146. [PMID: 35921596 DOI: 10.1097/jsa.0000000000000349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Knee osteoarthritis (OA) is a common condition, prevalent in middle-agedness, associated with chronic pain and impaired quality of life. Two interrelated biological processes fuel early OA progression: inflammation and structural tissues catabolism. Procatabolic and proinflammatory mediators are interconnected and form part of a self-perpetuating loop. They leverage OA research complexity because of the impossibility to discern certain spatiotemporal tissues' changes from others. Both are shared targets of versatile regenerative multimolecular therapies. In particular, platelet-rich plasma can interfere with inflammation and inflammatory pain. The therapeutic approach is to alter the vicious inflammatory loop by modifying the molecular composition of the synovial fluid, thereby paracrine cellular cross talk. Intra-articular injections of platelet-rich plasma can provide key factors balancing proinflammatory and anti-inflammatory factors, targeting macrophage dysfunction and modulating immune mechanisms within the knee.
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