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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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2
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Zhang S, Zhao M, Sun J, Wen J, Li M, Wang C, Xu Q, Wang J, Sun X, Cheng L, Xue X, Wang X, Jia X. Alterations in degree centrality and functional connectivity in tension-type headache: a resting-state fMRI study. Brain Imaging Behav 2024:10.1007/s11682-024-00875-w. [PMID: 38512647 DOI: 10.1007/s11682-024-00875-w] [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] [Accepted: 03/08/2024] [Indexed: 03/23/2024]
Abstract
Previous studies have provided evidence of structural and functional changes in the brains of patients with tension-type headache (TTH). However, investigations of functional connectivity alterations in TTH have been inconclusive. The present study aimed to investigate abnormal intrinsic functional connectivity patterns in patients with TTH through the voxel-wise degree centrality (DC) method as well as functional connectivity (FC) analysis. A total of 33 patients with TTH and 30 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (rs-fMRI) scanning and were enrolled in the final study. The voxel-wise DC method was performed to quantify abnormalities in the local functional connectivity hubs. Nodes with abnormal DC were used as seeds for further FC analysis to evaluate alterations in functional connectivity patterns. In addition, correlational analyses were performed between abnormal DC and FC values and clinical features. Compared with HCs, patients with TTH had higher DC values in the left middle temporal gyrus (MTG.L) and lower DC values in the left anterior cingulate and paracingulate gyri (ACG.L) (GRF, voxel-wise p < 0.05, cluster-wise p < 0.05, two-tailed). Seed-based FC analyses revealed that patients with TTH showed greater connections between ACG.L and the right cerebellum lobule IX (CR-IX.R), and smaller connections between ACG.L and ACG.L. The MTG.L showed increased FC with the ACG.L, and decreased FC with the right caudate nucleus (CAU.R) and left precuneus (PCUN.L) (GRF, voxel-wise p < 0.05, cluster-wise p < 0.05, two-tailed). Additionally, the DC value of the MTG.L was negatively correlated with the DASS-depression score (p = 0.046, r=-0.350). This preliminary study provides important insights into the pathophysiological mechanisms of TTH.
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Affiliation(s)
- Shuxian Zhang
- Medical Imaging Center, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, 261031, China
| | - Mengqi Zhao
- School of Teacher Education, Zhejiang Normal University, Jinhua, 321004, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, 321004, China
| | - Jiazhang Sun
- Ophthalmologic Center, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, 261031, China
| | - Jianjie Wen
- School of Teacher Education, Zhejiang Normal University, Jinhua, 321004, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, 321004, China
| | - Mengting Li
- School of Teacher Education, Zhejiang Normal University, Jinhua, 321004, China
- Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, 321004, China
| | - Chao Wang
- Basic Support Department, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, 261031, China
| | - Qinyan Xu
- Medical Imaging Center, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, 261031, China
| | - Jili Wang
- School of Medical Imaging, Weifang Medical University, Weifang, Shandong Province, 261053, China
| | - Xihe Sun
- Medical Imaging Center, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, 261031, China
- School of Medical Imaging, Weifang Medical University, Weifang, Shandong Province, 261053, China
| | - Lulu Cheng
- School of Foreign Studies, China University of Petroleum (East China), Qingdao, Shandong Province, 266580, China
| | - Xiaomeng Xue
- School of Foreign Studies, China University of Petroleum (East China), Qingdao, Shandong Province, 266580, China.
| | - Xizhen Wang
- Medical Imaging Center, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, 261031, China.
| | - Xize Jia
- Medical Imaging Center, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, 261031, China.
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Tang Y, Shi Y, Xu Z, Hu J, Zhou X, Tan Y, Lan X, Zhou X, Yang J, Zhang J, Deng B, Liu D. Altered gray matter volume and functional connectivity in lung cancer patients with bone metastasis pain. J Neurosci Res 2024; 102. [PMID: 38284835 DOI: 10.1002/jnr.25256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 09/16/2023] [Accepted: 09/22/2023] [Indexed: 01/30/2024]
Abstract
Bone metastasis pain (BMP) is a severe chronic pain condition. Our previous studies on BMP revealed functional brain abnormalities. However, the potential effect of BMP on brain structure and function, especially gray matter volume (GMV) and related functional networks, have not yet been clearly illustrated. Voxel-based morphometry and functional connectivity (FC) analysis methods were used to investigate GMV and intrinsic FC differences in 45 right-handed lung cancer patients with BMP(+), 37 lung cancer patients without BMP(-), and 45 healthy controls (HCs). Correlation analysis was performed thereafter with all clinical variables by Pearson correlation. Compared to HCs, BMP(+) group exhibited decreased GMV in medial frontal gyrus (MFG) and right middle temporal gyrus (MTG). Compared with BMP(-) group, BMP(+) group exhibited reduced GMV in cerebelum_6_L and left lingual gyrus. However, no regions with significant GMV differences were found between BMP(-) and HCs groups. Receiver operating characteristic analysis indicated the potential classification power of these aberrant regions. Correlation analysis revealed that GMV in the right MTG was positively associated with anxiety in BMP(+) group. Further FC analysis demonstrated enhanced interactions between MFG/right MTG and cerebellum in BMP(+) patients compared with HCs. These results showed that BMP was closely associated with cerebral alterations, which may induce the impairment of pain moderation circuit, deficits in cognitive function, dysfunction of emotional control, and sensorimotor processing. These findings may provide a fresh perspective and further neuroimaging evidence for the possible mechanisms of BMP. Furthermore, the role of the cerebellum in pain processing needs to be further investigated.
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Affiliation(s)
- Yu Tang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Yumei Shi
- Department of Medical Oncology, Chongqing University Cancer Hospital, School of Medicine Chongqing University, Chongqing, China
| | - Zhen Xu
- Department of Medical Oncology, Chongqing University Cancer Hospital, School of Medicine Chongqing University, Chongqing, China
| | - Junlin Hu
- Department of Medical Oncology, Chongqing University Cancer Hospital, School of Medicine Chongqing University, Chongqing, China
| | - Xueying Zhou
- Department of Medical Oncology, Chongqing University Cancer Hospital, School of Medicine Chongqing University, Chongqing, China
| | - Yong Tan
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Xiaosong Lan
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Xiaoyu Zhou
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Jing Yang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Benmin Deng
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Daihong Liu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
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Titze C, Konietzny K, Gajsar H, Koltyn K, Chehadi O, Hasenbring MI, Vaegter HB. The role of spontaneous vs. experimentally induced attentional strategies for the pain response to a single bout of exercise in healthy individuals. Scand J Pain 2023; 23:588-598. [PMID: 37269072 DOI: 10.1515/sjpain-2022-0141] [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: 09/26/2022] [Accepted: 05/09/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Exercise-induced pain and exercise-induced hypoalgesia (EIH) are well described phenomena involving physiological and cognitive mechanisms. Two experiments explored whether spontaneous and instructed mindful monitoring (MM) were associated with reduced exercise-induced pain and unpleasantness, and increased EIH compared with spontaneous and instructed thought suppression (TS) in pain-free individuals. METHODS Eighty pain-free individuals participated in one of two randomized crossover experiments. Pressure pain thresholds (PPTs) were assessed at the leg, back and hand before and after 15 min of moderate-to-high intensity bicycling and a non-exercise control condition. Exercise-induced pain and unpleasantness were rated after bicycling. In experiment 1 (n=40), spontaneous attentional strategies were assessed with questionnaires. In experiment 2, participants (n=40) were randomly allocated to use either a TS or MM strategy during bicycling. RESULTS In experiment 1, the change in PPTs was significantly larger after exercise compared with quiet rest (p<0.05). Higher spontaneous MM was associated with less exercise-induced unpleasantness (r=-0.41, p<0.001), whereas higher spontaneous TS was associated with higher ratings of exercise-induced unpleasantness (r=0.35, p<0.05), but not with pain intensity or EIH. In experiment 2, EIH at the back was increased in participants using instructed TS compared with participants using instructed MM (p<0.05). CONCLUSIONS These findings suggest that spontaneous and presumably habitual (or dispositional) attentional strategies may primarily affect cognitive-evaluative aspects of exercise, such as feelings of exercise-induced unpleasantness. MM was related to less unpleasantness, whereas TS was related to higher unpleasantness. In terms of brief experimentally-induced instructions, TS seems to have an impact on physiological aspects of EIH; however, these preliminary findings need further research.
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Affiliation(s)
- Christina Titze
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Kerstin Konietzny
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Hannah Gajsar
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Kelli Koltyn
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Omar Chehadi
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Monika I Hasenbring
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | - Henrik Bjarke Vaegter
- Pain Research Group, Pain Center, Department of Anesthesiology and Intensive Care Medicine, University Hospital Odense, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Darnai G, Matuz A, Alhour HA, Perlaki G, Orsi G, Arató Á, Szente A, Áfra E, Nagy SA, Janszky J, Csathó Á. The neural correlates of mental fatigue and reward processing: A task-based fMRI study. Neuroimage 2023; 265:119812. [PMID: 36526104 DOI: 10.1016/j.neuroimage.2022.119812] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/07/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
Increasing time spent on the task (i.e., the time-on-task (ToT) effect) often results in mental fatigue. Typical effects of ToT are decreasing levels of task-related motivation and the deterioration of cognitive performance. However, a massive body of research indicates that the detrimental effects can be reversed by extrinsic motivators, for example, providing rewards to fatigued participants. Although several attempts have been made to identify brain areas involved in mental fatigue and related reward processing, the neural correlates are still less understood. In this study, we used the psychomotor vigilance task to induce mental fatigue and blood oxygen-level-dependent functional magnetic resonance imaging to investigate the neural correlates of the ToT effect and the reward effect (i.e., providing extra monetary reward after fatigue induction) in a healthy young sample. Our results were interpreted in a recently proposed neurocognitive framework. The activation of the right middle frontal gyrus, right insula and right anterior cingulate gyrus decreased as fatigue emerged and the cognitive performance dropped. However, after providing an extra reward, the cognitive performance, as well as activation of these areas, increased. Moreover, the activation levels of all of the mentioned areas were negatively associated with reaction times. Our results confirm that the middle frontal gyrus, insula and anterior cingulate cortex play crucial roles in cost-benefit evaluations, a potential background mechanism underlying fatigue, as suggested by the neurocognitive framework.
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Affiliation(s)
- Gergely Darnai
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary; Department of Neurology, Medical School, University of Pécs, Pécs, Hungary; ELKH-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - András Matuz
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | | | - Gábor Perlaki
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary; ELKH-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary; Pécs Diagnostic Centre, Pécs, Hungary
| | - Gergely Orsi
- ELKH-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary; Pécs Diagnostic Centre, Pécs, Hungary; Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary
| | - Ákos Arató
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
| | - Anna Szente
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary
| | - Eszter Áfra
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Szilvia Anett Nagy
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary; ELKH-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary; Pécs Diagnostic Centre, Pécs, Hungary; Structural Neurobiology Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - József Janszky
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary; ELKH-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.
| | - Árpád Csathó
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
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Medrano-Escalada Y, Plaza-Manzano G, Fernández-de-las-Peñas C, Valera-Calero JA. Structural, Functional and Neurochemical Cortical Brain Changes Associated with Chronic Low Back Pain. Tomography 2022; 8:2153-2163. [PMID: 36136876 PMCID: PMC9498382 DOI: 10.3390/tomography8050180] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/16/2022] [Accepted: 08/22/2022] [Indexed: 12/19/2022] Open
Abstract
Chronic low back pain (CLBP) is one of the most prevalent musculoskeletal disorders, being one of the leading contributors to disability worldwide and involving an important economic and social burden. Up to 90% of CLBP is non-specific (not associated with specific injuries), with a chronicity expectation estimated at 10%. Currently, motivational and emotional central circuits are being investigated due to their role in CLBP persistency and chronification. Therefore, this narrative review aimed to summarize the evidence regarding the cortical brain changes described for proposing novel multidisciplinary approaches. Novel advances in neuroimaging techniques demonstrated structural (e.g., decrease in the grey matter located at the dorsolateral prefrontal cortex), functional (e.g., connectivity impairments in those areas involved in pain processing), and neurochemical changes (e.g., decrease in cerebral metabolites). In addition, significant changes were found in the primary somatosensory and motor cortex, contributing to the alteration of low back muscles activation and function.
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Affiliation(s)
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Grupo InPhysio, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913-941-545
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Clínica e Investigación en Fisioterapia, Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Juan Antonio Valera-Calero
- VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
- Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
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Fang Y, Chen C, Zhong Q, Wang L, Gui Z, Zhu J, Manyande A, Xu F, Wang J, Zhang Z. Influence of Cerebral Glucose Metabolism by Chronic Pain-Mediated Cognitive Impairment in Adolescent Rats. Mol Neurobiol 2022; 59:3635-3648. [PMID: 35355195 DOI: 10.1007/s12035-022-02816-4] [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: 11/22/2021] [Accepted: 03/23/2022] [Indexed: 11/25/2022]
Abstract
Chronic pain during adolescence can lead to mental health disorders in adulthood, but the underlying mechanism is still unclear. Furthermore, the homeostasis of cerebral glucose metabolism and neurotransmitter metabolic kinetics are closely associated with cognitive development and pain progression. The present study investigated changes in cognitive function and glucose metabolism in adult rats, which had experienced chronic pain during their adolescence. Here, spared nerve injury (SNI) surgery was conducted in 4-week-old male rats. Mechanical nociceptive reflex thresholds were analyzed, and SNI chronic pain (SNI-CP) animals were screened. Based on animal behavioral tests (open field, three-chambered social, novel object recognition and the Y maze), the SNI-CP animals showed learning and memory impairment and anxiety-like behaviors, compared to SNI no chronic pain (SNI-NCP) animals. The cerebral glucose metabolism in the prefrontal cortex and hippocampus of adult SNI-CP animals was decreased with positron emission tomography/computed tomography. GABA2 and Glu4 levels in the metabolic kinetics study were significantly decreased in the hippocampus, frontal cortex, and temporal cortex, and the expression of GLUT3 and GLUT4 was also significantly downregulated in the prefrontal cortex and hippocampus of adult rats in the SNI-CP group. These findings suggest that the rats which suffered chronic pain during adolescence have lower cerebral glucose metabolism in the cortex and hippocampus, which could be related to cognitive function during the development of the central nervous system.
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Affiliation(s)
- Yuanyuan Fang
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - Chang Chen
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - Qi Zhong
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - Lirong Wang
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - Zhu Gui
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, Hubei, 430071, People's Republic of China
| | - Jinpiao Zhu
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, Hubei, 430071, People's Republic of China
| | - Anne Manyande
- School of Human and Social Sciences, University of West London, Brentford, TW8 9GA, Middlesex, UK
| | - Fuqiang Xu
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, Hubei, 430071, People's Republic of China
| | - Jie Wang
- Key Laboratory of Magnetic Resonance in Biological Systems, State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences-Wuhan National Laboratory for Optoelectronics, Wuhan, Hubei, 430071, People's Republic of China.
- Institute of Neuroscience and Brain Diseases, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, People's Republic of China.
- University of Chinese Academy of Sciences, Beijing, 100049, People's Republic of China.
| | - Zongze Zhang
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, People's Republic of China.
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8
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Schankin CJ, Maniyar FH, Chou DE, Eller M, Sprenger T, Goadsby PJ. Structural and functional footprint of visual snow syndrome. Brain 2020; 143:1106-1113. [PMID: 32211752 PMCID: PMC7534145 DOI: 10.1093/brain/awaa053] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 01/14/2020] [Accepted: 01/16/2020] [Indexed: 11/28/2022] Open
Abstract
Patients with visual snow syndrome suffer from a continuous pan-field visual disturbance, additional visual symptoms, tinnitus, and non-perceptional symptoms. The pathophysiology of visual symptoms might involve dysfunctional visual cortex. So far, the extra-visual system has not been investigated. We aimed at identifying structural and functional correlates for visual and non-visual symptoms in visual snow syndrome. Patients were compared to age- and sex-matched controls using 18F-2-fluoro-2-deoxy-d-glucose PET (n = 20 per group) and voxel-based morphometry (n = 17 per group). Guided by the PET results, region of interest analysis was done in voxel-based morphometry to identify structural-functional correspondence. Grey matter volume was assessed globally. Patients had corresponding hypermetabolism and cortical volume increase in the extrastriate visual cortex at the junction of the right lingual and fusiform gyrus. There was hypometabolism in the right superior temporal gyrus and the left inferior parietal lobule. Patients had grey matter volume increases in the temporal and limbic lobes and decrease in the superior temporal gyrus. The corresponding structural and functional alterations emphasize the relevance of the visual association cortex for visual snow syndrome. The broad structural and functional footprint, however, confirms the clinical impression that the disorder extends beyond the visual system.
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Affiliation(s)
- Christoph J Schankin
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.,Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Farooq H Maniyar
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.,Department of Neurology, The Royal London Hospital (Barts and the London NHS Trust), London, UK
| | - Denise E Chou
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.,Amgen Inc., Thousand Oaks, CA USA
| | - Michael Eller
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.,Department of Neurology, Monash Medical Centre, Monash University, Melbourne, Australia
| | - Till Sprenger
- Department of Neurology, DKD HELIOS Klinik Wiesbaden, Wiesbaden, Germany
| | - Peter J Goadsby
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.,NIHR-Wellcome Trust King's Clinical Research Facility, SLaM Biomedical Research Center, King's College London, London, UK
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9
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Pain Education With Therapeutic Exercise in Chronic Nonspecific Low Back Pain Rehabilitation: A Critically Appraised Topic. J Sport Rehabil 2020; 29:1204-1209. [PMID: 32106086 DOI: 10.1123/jsr.2019-0345] [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: 07/31/2019] [Revised: 10/15/2019] [Accepted: 01/02/2020] [Indexed: 11/18/2022]
Abstract
Clinical Scenario: Low back pain is widely prevalent in the general population as well as in athletes. Therapeutic exercise is a low-risk and effective treatment option for chronic pain that can be utilized by all rehabilitation clinicians. However, therapeutic exercise alone does not address the psychosocial aspects that are associated with chronic low back pain. Pain education is the umbrella term utilized to encompass any type of education to the patient about their chronic pain. Therapeutic exercise in combination with pain education may allow for more well-rounded and effective treatment for patients with chronic nonspecific low back pain (NS-LBP). Clinical Question: Does pain education combined with therapeutic exercise, compared with therapeutic exercise alone, improve patient pain in adults with chronic NS-LBP over a 2- to 3-month treatment period? Summary of Key Findings: A thorough literature review yielded 8 studies potentially relevant to the clinical question, and 3 studies that met the inclusion criteria were included. The 3 studies included reports that exercise therapy reduced symptoms. Two of the 3 included studies support the claim that exercise therapy reduces the symptoms of chronic NS-LBP when combined with pain education, whereas one study found no difference between pain education with therapeutic exercise. Clinical Bottom Line: There is moderate evidence to support the use of pain education along with therapeutic exercise when attempting to reduce symptoms of pain and disability in patients with chronic NS-LBP. Educational interventions should be created to educate patients about the foundation of pain, and pain education should be implemented as a part of the clinician's strategy for the rehabilitation of patients with chronic NS-LBP. Strength of Recommendation: Grade B evidence exists to support the use of patient education with therapeutic exercise for decreasing pain in patients with chronic NS-LBP.
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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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Vitoula K, Venneri A, Varrassi G, Paladini A, Sykioti P, Adewusi J, Zis P. Behavioral Therapy Approaches for the Management of Low Back Pain: An Up-To-Date Systematic Review. Pain Ther 2018; 7:1-12. [PMID: 29767395 PMCID: PMC5993685 DOI: 10.1007/s40122-018-0099-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Indexed: 01/21/2023] Open
Abstract
Low back pain is one of the most common causes for seeking medical treatment and it is estimated that one in two people will experience low back pain at some point during their lifetimes. Management of low back pain includes pharmacological and non-pharmacological approaches. Non-pharmaceutical treatments include interventions such as acupuncture, spinal manipulation, and psychotherapy. The latter is especially important as patients who suffer from low back pain often have impaired quality of life and also suffer from depression. Depressive symptoms can appear because back pain limits patients’ ability to work and engage in their usual social activities. The aim of this systematic review was to overview the behavioral approaches that can be used in the management of patients with low back pain. Approaches such as electromyography (EMG) biofeedback, cognitive behavioral therapy, and mindfulness-based stress reduction are discussed as non-pharmacological options in the management of low back pain.
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Affiliation(s)
- Kristallia Vitoula
- Department of Anesthesiology, Attica General Hospital KAT, Athens, Greece
| | - Annalena Venneri
- Department of Neurosciences, University of Sheffield, Sheffield, UK
| | | | | | | | - Joy Adewusi
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Panagiotis Zis
- Academic Department of Neurosciences, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
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Roy M, Vachon-Presseau É. Grey correlations: A commentary on Chehadi et al. Eur J Pain 2018; 22:1029-1031. [PMID: 29573514 DOI: 10.1002/ejp.1216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 11/06/2022]
Affiliation(s)
- M Roy
- Department of Psychology, McGill University, Montréal, QC, Canada.,Centre de Recherche de l'Institut, Universitaire de Gériatrie de Montréal, QC, Canada.,The Alan Edwards Centre for research on Pain, McGill University, Montréal, QC, Canada
| | - É Vachon-Presseau
- Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, USA
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