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Wei HL, Yu YS, Wang MY, Zhou GP, Li J, Zhang H, Zhou Z. Exploring potential neuroimaging biomarkers for the response to non-steroidal anti-inflammatory drugs in episodic migraine. J Headache Pain 2024; 25:104. [PMID: 38902598 PMCID: PMC11191194 DOI: 10.1186/s10194-024-01812-4] [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: 05/14/2024] [Accepted: 06/13/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Non-steroidal anti-inflammatory drugs (NSAIDs) are considered first-line medications for acute migraine attacks. However, the response exhibits considerable variability among individuals. Thus, this study aimed to explore a machine learning model based on the percentage of amplitude oscillations (PerAF) and gray matter volume (GMV) to predict the response to NSAIDs in migraine treatment. METHODS Propensity score matching was adopted to match patients having migraine with response and nonresponse to NSAIDs, ensuring consistency in clinical characteristics and migraine-related features. Multimodal magnetic resonance imaging was employed to extract PerAF and GMV, followed by feature selection using the least absolute shrinkage and selection operator regression and recursive feature elimination algorithms. Multiple predictive models were constructed and the final model with the smallest predictive residuals was chosen. The model performance was evaluated using the area under the receiver operating characteristic (ROCAUC) curve, area under the precision-recall curve (PRAUC), balance accuracy (BACC), sensitivity, F1 score, positive predictive value (PPV), and negative predictive value (NPV). External validation was performed using a public database. Then, correlation analysis was performed between the neuroimaging predictors and clinical features in migraine. RESULTS One hundred eighteen patients with migraine (59 responders and 59 non-responders) were enrolled. Six features (PerAF of left insula and left transverse temporal gyrus; and GMV of right superior frontal gyrus, left postcentral gyrus, right postcentral gyrus, and left precuneus) were observed. The random forest model with the lowest predictive residuals was selected and model metrics (ROCAUC, PRAUC, BACC, sensitivity, F1 score, PPV, and NPV) in the training and testing groups were 0.982, 0.983, 0.927, 0.976, 0.930, 0.889, and 0.973; and 0.711, 0.648, 0.639, 0.667,0.649, 0.632, and 0.647, respectively. The model metrics of external validation were 0.631, 0.651, 0.611, 0.808, 0.656, 0.553, and 0.706. Additionally, a significant positive correlation was found between the GMV of the left precuneus and attack time in non-responders. CONCLUSIONS Our findings suggest the potential of multimodal neuroimaging features in predicting the efficacy of NSAIDs in migraine treatment and provide novel insights into the neural mechanisms underlying migraine and its optimized treatment strategy.
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Affiliation(s)
- Heng-Le Wei
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No.169, Hushan Road, Nanjing, China
| | - Yu-Sheng Yu
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No.169, Hushan Road, Nanjing, China
| | - Meng-Yao Wang
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No.169, Hushan Road, Nanjing, China
| | - Gang-Ping Zhou
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No.169, Hushan Road, Nanjing, China
| | - Junrong Li
- Department of Neurology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China.
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, No.169, Hushan Road, Nanjing, China.
| | - Zhengyang Zhou
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
- Department of Radiology, Nanjing Drum Tower Hospital, Nanjing, China.
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Wang G, Chen X, Wang X, Duan Y, Gao H, Ji X, Zhu Y, Xiang X, Ma H, Li Y, Xue Q. Abnormal brain spontaneous neural activity in neuromyelitis optica spectrum disorder with neuropathic pain. Front Neurol 2024; 15:1408759. [PMID: 38938780 PMCID: PMC11210278 DOI: 10.3389/fneur.2024.1408759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/30/2024] [Indexed: 06/29/2024] Open
Abstract
Background Neuropathic pain is one of the most common symptoms in neuromyelitis optica spectrum disorder (NMOSD). Notwithstanding, its underlying mechanism remains obscure. Methods The amplitude of low-frequency fluctuations (ALFF) metric was employed to investigate spontaneous neural activity alterations via resting-state functional magnetic resonance imaging (rs-MRI) data from a 3.0 T MRI scanner, in a sample of 26 patients diagnosed with NMOSD with neuropathic pain (NMOSD-WNP), 20 patients with NMOSD but without neuropathic pain (NMOSD-WoNP), and 38 healthy control (HC) subjects matched for age and sex without the comorbidity of depressive or anxious symptoms. Results It was observed that patients with NMOSD-WNP displayed a significant ALFF decrease in the left amygdala and right anterior insula, relative to both patients with NMOSD-WoNP and HC subjects. Furthermore, ALFF values in the left amygdala were negatively correlated with the scores of the Douleur Neuropathique en 4 Questions and McGill Pain Questionnaire (both sensory and affective descriptors) in patients with NMOSD-WNP. Additionally, there were negative correlations between the ALFF values in the right anterior insula and the duration of pain and the number of relapses in patients with NMOSD-WNP. Conclusion The present study characterizes spontaneous neural activity changes in brain regions associated with sensory and affective processing of pain and its modulation, which underscore the central aspects in patients with NMOSD-WNP. These findings might contribute to a better understanding of the pathophysiologic basis of neuropathic pain in NMOSD.
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Affiliation(s)
- Gendi Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Neurology, Yancheng Third People’s Hospital, Yancheng, China
| | - Xiang Chen
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoyuan Wang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yinghui Duan
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hanqing Gao
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaopei Ji
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yunfei Zhu
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xuanyi Xiang
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hairong Ma
- Department of Neurology, Kunshan Hospital of Chinese Medicine, Suzhou, China
| | - Yonggang Li
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Medical Imaging, Soochow University, Suzhou, China
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qun Xue
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Clinical Immunology, Jiangsu Institute of Clinical Immunology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Bai X, Wang W, Zhang X, Hu Z, Zhang X, Zhang Y, Tang H, Zhang Y, Yu X, Yuan Z, Zhang P, Li Z, Pei X, Wang Y, Sui B. Hyperperfusion of bilateral amygdala in patients with chronic migraine: an arterial spin-labeled magnetic resonance imaging study. J Headache Pain 2023; 24:138. [PMID: 37848831 PMCID: PMC10583377 DOI: 10.1186/s10194-023-01668-0] [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: 08/29/2023] [Accepted: 09/21/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Amygdala, an essential element of the limbic system, has served as an important structure in pain modulation. There is still a lack of clarity about altered cerebral perfusion of amygdala in migraine. This study aimed to investigate the perfusion variances of bilateral amygdala in episodic migraine (EM) and chronic migraine (CM) using multi-delay pseudo-continuous arterial spin-labeled magnetic resonance imaging (pCASL-MRI). METHODS Twenty-six patients with EM, 55 patients with CM (33 CM with medication overuse headache (MOH)), and 26 age- and sex-matched healthy controls (HCs) were included. All participants underwent 3D multi-delay pCASL MR imaging to obtain cerebral perfusion data, including arrival-time-corrected cerebral blood flow (CBF) and arterial cerebral blood volume (aCBV). The CBF and aCBV values in the bilateral amygdala were compared among the three groups. Correlation analyses between cerebral perfusion parameters and clinical variables were performed. RESULTS Compared with HC participants, patients with CM were found to have increased CBF and aCBV values in the left amygdala, as well as increased CBF values in the right amygdala (all P < 0.05). There were no significant differences of CBF and aCBV values in the bilateral amygdala between the HC and EM groups, the EM and CM groups, as well as the CM without and with MOH groups (all P > 0.05). In patients with CM, the increased perfusion parameters of bilateral amygdala were positively correlated with MIDAS score after adjustments for age, sex, and body mass index (BMI). CONCLUSION Hyperperfusion of bilateral amygdala might provide potential hemodynamics evidence in the neurolimbic pain network of CM.
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Affiliation(s)
- Xiaoyan Bai
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital and Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 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
| | - Xueyan Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Xue Zhang
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital and Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yingkui Zhang
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital and Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, 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
| | - 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
| | - 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
| | - 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
| | - Zhiye Li
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital and Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xun Pei
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital and Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 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.
| | - Binbin Sui
- Tiantan Neuroimaging Center for Excellence, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital and Beijing Neurosurgical Institute, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, China.
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FDG PET Imaging of the Pain Matrix in Neuropathic Pain Model Rats. Biomedicines 2022; 11:biomedicines11010063. [PMID: 36672571 PMCID: PMC9855331 DOI: 10.3390/biomedicines11010063] [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: 11/15/2022] [Revised: 12/03/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
Pain is an unpleasant subjective experience that is usually modified by complex multidimensional neuropsychological processes. Increasing numbers of neuroimaging studies in humans have characterized the hierarchical brain areas forming a pain matrix, which is involved in the different dimensions of pain components. Although mechanistic investigations have been performed extensively in rodents, the homologous brain regions involved in the multidimensional pain components have not been fully understood in the rodent brain. Herein, we successfully identified several brain regions activated in response to mechanical allodynia in neuropathic pain rat models using an alternative neuroimaging method based on 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography (FDG PET) scanning. Regions such as the medial prefrontal cortex, primary somatosensory cortex hindlimb region, and the centrolateral thalamic nucleus were identified. Moreover, brain activity in these regions was positively correlated with mechanical allodynia-related behavioral changes. These results suggest that FDG PET imaging in neuropathic pain model rats enables the evaluation of regional brain activity encoding the multidimensional pain aspect. It could thus be a fascinating tool to bridge the gap between preclinical and clinical investigations.
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Zhou Q, Li M, Fan Q, Chen F, Jiang G, Wang T, He Q, Fu S, Yin Y, Lin J, Yan J. Cerebral perfusion alterations in patients with trigeminal neuralgia as measured by pseudo-continuous arterial spin labeling. Front Neurosci 2022; 16:1065411. [PMID: 36601595 PMCID: PMC9807247 DOI: 10.3389/fnins.2022.1065411] [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: 10/09/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Background Accumulating evidence suggests that trigeminal neuralgia (TN) causes structural and functional alterations in the brain. However, only a few studies have focused on cerebral blood flow (CBF) changes in patients with TN. This study aimed to explore whether altered cerebral perfusion patterns exist in patients with TN and investigate the relationship between abnormal regional CBF (rCBF) and clinical characteristics of TN. Materials and methods This study included 28 patients with TN and 30 age- and sex-matched healthy controls (HCs) who underwent perfusion functional MRI (fMRI) of the brain using pseudo-continuous arterial spin labeling (pCASL) in the resting state. The regions of significantly altered CBF in patients with TN were detected using group comparison analyses. Then, the relationships between the clinical characteristics and abnormal rCBF were further investigated. Results Compared to the control group, patients with TN exhibited increased rCBF, primarily in the thalamus, middle frontal gyrus (MFG), and left insula. Furthermore, the CBF values of the thalamus were negatively correlated with the pain intensity of TN and positively correlated with pain duration in patients with TN. Conclusion Primary alterations in rCBF in patients with TN occurred in different brain regions related to pain, which are involved in cognitive-affective interaction, pain perception, and pain modulation. These results indicate that non-invasive resting cerebral perfusion imaging may contribute complementary information to further understanding the neuropathological mechanism underlying TN.
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Affiliation(s)
- Qianling Zhou
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China,Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Meng Li
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Qisen Fan
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Feng Chen
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Tianyue Wang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Qinmeng He
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Shishun Fu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yi Yin
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jinzhi Lin
- Department of Neurosurgery, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jianhao Yan
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China,Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China,*Correspondence: Jianhao Yan,
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Argaman Y, Granovsky Y, Sprecher E, Sinai A, Yarnitsky D, Weissman-Fogel I. Resting-state functional connectivity predicts motor cortex stimulation-dependent pain relief in fibromyalgia syndrome patients. Sci Rep 2022; 12:17135. [PMID: 36224244 PMCID: PMC9556524 DOI: 10.1038/s41598-022-21557-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/28/2022] [Indexed: 01/04/2023] Open
Abstract
MRI-based resting-state functional connectivity (rsFC) has been shown to predict response to pharmacological and non-pharmacological treatments for chronic pain, but not yet for motor cortex transcranial magnetic stimulation (M1-rTMS). Twenty-seven fibromyalgia syndrome (FMS) patients participated in this double-blind, crossover, and sham-controlled study. Ten daily treatments of 10 Hz M1-rTMS were given over 2 weeks. Before treatment series, patients underwent resting-state fMRI and clinical pain evaluation. Significant pain reduction occurred following active, but not sham, M1-rTMS. The following rsFC patterns predicted reductions in clinical pain intensity after the active treatment: weaker rsFC of the default-mode network with the middle frontal gyrus (r = 0.76, p < 0.001), the executive control network with the rostro-medial prefrontal cortex (r = 0.80, p < 0.001), the thalamus with the middle frontal gyrus (r = 0.82, p < 0.001), and the pregenual anterior cingulate cortex with the inferior parietal lobule (r = 0.79, p < 0.001); and stronger rsFC of the anterior insula with the angular gyrus (r = - 0.81, p < 0.001). The above regions process the attentional and emotional aspects of pain intensity; serve as components of the resting-state networks; are modulated by rTMS; and are altered in FMS. Therefore, we suggest that in FMS, the weaker pre-existing interplay between pain-related brain regions and networks, the larger the pain relief resulting from M1-rTMS.
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Affiliation(s)
- Yuval Argaman
- grid.6451.60000000121102151Clinical Neurophysiology Lab, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
| | - Yelena Granovsky
- grid.6451.60000000121102151Clinical Neurophysiology Lab, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel ,grid.413731.30000 0000 9950 8111Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - Elliot Sprecher
- grid.413731.30000 0000 9950 8111Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - Alon Sinai
- grid.413731.30000 0000 9950 8111Department of Neurosurgery, Rambam Health Care Campus, Haifa, Israel
| | - David Yarnitsky
- grid.6451.60000000121102151Clinical Neurophysiology Lab, Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel ,grid.413731.30000 0000 9950 8111Department of Neurology, Rambam Health Care Campus, Haifa, Israel
| | - Irit Weissman-Fogel
- grid.18098.380000 0004 1937 0562Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Abstract
Pain is an unpleasant sensory and emotional experience. Understanding the neural mechanisms of acute and chronic pain and the brain changes affecting pain factors is important for finding pain treatment methods. The emergence and progress of non-invasive neuroimaging technology can help us better understand pain at the neural level. Recent developments in identifying brain-based biomarkers of pain through advances in advanced imaging can provide some foundations for predicting and detecting pain. For example, a neurologic pain signature (involving brain regions that receive nociceptive afferents) and a stimulus intensity-independent pain signature (involving brain regions that do not show increased activity in proportion to noxious stimulus intensity) were developed based on multivariate modeling to identify processes related to the pain experience. However, an accurate and comprehensive review of common neuroimaging techniques for evaluating pain is lacking. This paper reviews the mechanism, clinical application, reliability, strengths, and limitations of common neuroimaging techniques for assessing pain to promote our further understanding of pain.
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Affiliation(s)
- Jing Luo
- Department of Sport Rehabilitation, Xian Physical Education University, Xian, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Hui-Qi Zhu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Sport Rehabilitation, Shenyang Sport University, Shenyang, China
| | - Bo Gou
- Department of Sport Rehabilitation, Xian Physical Education University, Xian, China.
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
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Resting-State Functional Connectivity Analyses: Brain Functional Reorganization in a Rat Model of Postherpetic Neuralgia. Brain Sci 2022; 12:brainsci12081029. [PMID: 36009092 PMCID: PMC9405817 DOI: 10.3390/brainsci12081029] [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: 06/09/2022] [Revised: 07/20/2022] [Accepted: 08/01/2022] [Indexed: 11/17/2022] Open
Abstract
Postherpetic neuralgia (PHN) is a chronic neuropathic pain syndrome, similar to other chronic pains, the mechanisms of which are not fully understood. To further understand the neural mechanism of this chronic pain and its transition, we performed functional magnetic resonance imaging (fMRI) scans on PHN rat models. Twelve PHN rat models were established by intraperitoneal injection of resiniferatoxin, with an additional 12 rats serving as controls. Nociceptive behavioral tests were performed on these rats and fMRI scans were performed on days 7 and 14 after modeling. Functional connection (FC) analysis was used to investigate the brain FC alterations associated with chronic pain in PHN rats, with the anterior cingulate cortex (ACC) as a seed. Nociceptive behavioral tests showed that PHN rats presented symptoms similar to those of PHN patients. FC analysis showed that compared to the control group, the PHN group showed different FC patterns on days 7 and 14. As can be seen, the brain FC alterations in the rat model of PHN changed dynamically, shifting from brain regions processing sensory information to regions processing emotions and motives.
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Li H, Li X, Wang J, Gao F, Wiech K, Hu L, Kong Y. Pain-related reorganization in the primary somatosensory cortex of patients with postherpetic neuralgia. Hum Brain Mapp 2022; 43:5167-5179. [PMID: 35751551 PMCID: PMC9812237 DOI: 10.1002/hbm.25992] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 06/05/2022] [Accepted: 06/10/2022] [Indexed: 01/15/2023] Open
Abstract
Studies on functional and structural changes in the primary somatosensory cortex (S1) have provided important insights into neural mechanisms underlying several chronic pain conditions. However, the role of S1 plasticity in postherpetic neuralgia (PHN) remains elusive. Combining psychophysics and magnetic resonance imaging (MRI), we investigated whether pain in PHN patients is linked to S1 reorganization as compared with healthy controls. Results from voxel-based morphometry showed no structural differences between groups. To characterize functional plasticity, we compared S1 responses to noxious laser stimuli of a fixed intensity between both groups and assessed the relationship between S1 activation and spontaneous pain in PHN patients. Although the intensity of evoked pain was comparable in both groups, PHN patients exhibited greater activation in S1 ipsilateral to the stimulated hand. Pain-related activity was identified in contralateral superior S1 (SS1) in controls as expected, but in bilateral inferior S1 (IS1) in PHN patients with no overlap between SS1 and IS1. Contralateral SS1 engaged during evoked pain in controls encoded spontaneous pain in patients, suggesting functional S1 reorganization in PHN. Resting-state fMRI data showed decreased functional connectivity between left and right SS1 in PHN patients, which scaled with the intensity of spontaneous pain. Finally, multivariate pattern analyses (MVPA) demonstrated that BOLD activity and resting-state functional connectivity of S1 predicted within-subject variations of evoked and spontaneous pain intensities across groups. In summary, functional reorganization in S1 might play a key role in chronic pain related to PHN and could be a potential treatment target in this patient group.
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Affiliation(s)
- Hong Li
- CAS Key Laboratory of Behavioral ScienceInstitute of PsychologyBeijingChina,Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Xiaoyun Li
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina,CAS Key Laboratory of Mental HealthInstitute of PsychologyBeijingChina
| | - Jiyuan Wang
- CAS Key Laboratory of Behavioral ScienceInstitute of PsychologyBeijingChina,Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Fei Gao
- Department of Pain MedicinePeking University People's HospitalBeijingChina
| | - Katja Wiech
- Wellcome Centre for Integrative Neuroimaging (WIN), Nuffield Department of Clinical NeurosciencesUniversity of Oxford, John Radcliffe HospitalOxfordUK
| | - Li Hu
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina,CAS Key Laboratory of Mental HealthInstitute of PsychologyBeijingChina
| | - Yazhuo Kong
- CAS Key Laboratory of Behavioral ScienceInstitute of PsychologyBeijingChina,Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina,Wellcome Centre for Integrative Neuroimaging (WIN), Nuffield Department of Clinical NeurosciencesUniversity of Oxford, John Radcliffe HospitalOxfordUK
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Aberrant Spontaneous Brain Activity in Coronary Heart Disease Using Fractional Amplitude of Low-Frequency Fluctuations: A Preliminary Resting-State Functional MRI Study. DISEASE MARKERS 2022; 2022:2501886. [PMID: 35692880 PMCID: PMC9187430 DOI: 10.1155/2022/2501886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/14/2022] [Accepted: 05/17/2022] [Indexed: 11/18/2022]
Abstract
Objective This study is aimed at exploring the spontaneous brain activity changes by measuring the fractional amplitude of low-frequency fluctuations (fALFF) and their relationship with clinical characteristics in patients with coronary heart disease (CHD). Methods Coronary heart disease patients (n = 25) and age, gender, and education level-matched control subjects (controls, n = 35) were included. The grey matter volume (GMV) and fALFF values were calculated to assess the difference in brain structure and function between the two groups, respectively. Correlation analyses between the fALFF values and clinical characteristics were further assessed in CHD patients. In addition, receiver operating characteristic (ROC) curves were conducted to access the diagnostic ability of the fALFF method. Results There was no significant difference in GMV between the CHD and control groups. Compared with the control group, patients with CHD showed significantly decreased fALFF in the left precentral/postcentral gyrus and increased fALFF in the right inferior cerebellum. Patients with a history of myocardial infarction (MI) showed significantly decreased fALFF values of the right inferior cerebellum than patients without MI. There was no significant correlation between the fALFF values in specific brain regions and disease duration. Furthermore, the ROC curves of abnormal brain regions showed the perfect accuracy of the fALFF value in distinguishing between CHD patients and controls. Conclusion CHD demonstrated aberrant neural activity in specific brain regions mainly related to sensorimotor networks and pain processing, which may contribute to understanding the underlying neurological mechanism of CHD.
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Nakamura Y, Uematsu A, Okanoya K, Koike S. The effect of acquisition duration on cerebral blood flow-based resting-state functional connectivity. Hum Brain Mapp 2022; 43:3184-3194. [PMID: 35338768 PMCID: PMC9189081 DOI: 10.1002/hbm.25843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 02/24/2022] [Accepted: 03/10/2022] [Indexed: 11/10/2022] Open
Abstract
Resting-state functional connectivity (rs-FC) is widely used to examine the functional architecture of the brain, and the blood-oxygenation-level-dependent (BOLD) signal is often utilized for determining rs-FC. However, the BOLD signal is susceptible to various factors that have less influence on the cerebral blood flow (CBF). Therefore, CBF could comprise an alternative for determining rs-FC. Since acquisition duration is one of the essential parameters for obtaining reliable rs-FC, we investigated the effect of acquisition duration on CBF-based rs-FC to examine the reliability of CBF-based rs-FC. Nineteen participants underwent CBF scanning for a total duration of 50 min. Variance of CBF-based rs-FC within the whole brain and 13 large-scale brain networks at various acquisition durations was compared to that with a 50-min duration using the Levene's test. Variance of CBF-based rs-FC at any durations did not differ from that at a 50-min duration (p > .05). Regarding variance of rs-FC within each large-scale brain network, the acquisition duration required to obtain reliable estimates of CBF-based rs-FC was shorter than 10 min and varied across large-scale brain networks. Altogether, an acquisition duration of at least 10 min is required to obtain reliable CBF-based rs-FC. These results indicate that CBF-based resting-state functional magnetic resonance imaging (rs-fMRI) with more than 10 min of total acquisition duration could be an alternative method to BOLD-based rs-fMRI to obtain reliable rs-FC.
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Affiliation(s)
- Yuko Nakamura
- The UTokyo Center for Integrative Science of Human Behavior (CiSHuB), The University of Tokyo, 3-8-1, Komaba, Meguro-ku, Tokyo, Japan
| | - Akiko Uematsu
- Laboratory for Brain Connectomics Imaging, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
| | - Kazuo Okanoya
- The UTokyo Center for Integrative Science of Human Behavior (CiSHuB), The University of Tokyo, 3-8-1, Komaba, Meguro-ku, Tokyo, Japan.,University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Tokyo, Japan.,International Research Center for Neurointelligence (IRCN), Tokyo, Japan.,Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan.,Cognition and Behavior Joint Research Laboratory, RIKEN Center for Brain Science, Saitama, Japan
| | - Shinsuke Koike
- The UTokyo Center for Integrative Science of Human Behavior (CiSHuB), The University of Tokyo, 3-8-1, Komaba, Meguro-ku, Tokyo, Japan.,University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Tokyo, Japan.,International Research Center for Neurointelligence (IRCN), Tokyo, Japan
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12
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Xue S, Yang WJ, Cao ZX, Sun T. Comparing the efficacy and safety of short-term spinal cord stimulation and pulsed radiofrequency for zoster-related pain: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e29073. [PMID: 35356934 PMCID: PMC10684147 DOI: 10.1097/md.0000000000029073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/24/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Pulsed radiofrequency (PRF) is a commonly used method for the treatment of zoster-related pain in the clinic. However, PRF therapy has a high recurrence rate and many adverse reactions. Recent studies have shown that short-term spinal cord stimulation (stSCS) can effectively alleviate zoster-related pain. Due to the lack of evidence, it is unclear whether stSCS is superior to PRF in the efficacy of treating zoster-related pain. OBJECTIVE This study aimed to compare the efficacy and safety of stSCS and PRF for zoster-related pain. METHODS We searched seven electronic databases from the establishment of the database to January 2021. Related randomized controlled trials were included in this meta-analysis. After extracting the data and evaluating the methodological quality of the included trials, the outcome indicators were statistically analyzed by using RevManV.5.3. RESULTS This meta-analysis included 6 trials with a total of 509 patients. Compared with PRF group, stSCS group showed lower pain intensity (standardized mean difference=-0.83, 95%CI [-1.37, -0.30], P=.002), better sleep quality (mean difference=-1.43, 95%CI [-2.29, -0.57], P=.001), lower pain rating index scores, and less incidence of adverse events (RR=0.32, 95%CI [0.12, 0.83], P<.05). However, the efficacies of PRF and stSCS for treating postherpetic neuralgia were consistent in the response rate (RR= 1.10, 95% CI [0.82, 1.48], P=.51) and the complete remission rate (RR=1.05, 95% CI [0.66, 1.68], P=.84). CONCLUSIONS In this study, stSCS showed a better analgesic effect and higher safety than PRF. Our meta-analysis results suggested that stSCS may be a feasible and safe invasive treatment for zoster-related pain. However, high-quality, randomized controlled trials with large sample sizes are needed to further verify our conclusions.
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Affiliation(s)
| | | | | | - Tao Sun
- Correspondence: Tao Sun, Department of Pain Management, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, 324 Jingwu Road, Jinan, 250021, China (e-mail: ).
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13
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Chiang MC, Hsueh HW, Yeh TY, Cheng YY, Kao YH, Chang KC, Feng FP, Chao CC, Hsieh ST. Maladaptive motor cortical excitability and connectivity in polyneuropathy with neuropathic pain. Eur J Neurol 2022; 29:1465-1476. [PMID: 35020255 DOI: 10.1111/ene.15247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sensory symptoms, especially neuropathic pain, are common in polyneuropathy. Conventional diagnostic tools can evaluate structural or functional impairment of nerves but cannot reveal mechanisms of neuropathic pain. Changes in the brain after polyneuropathy may play roles in the genesis of neuropathic pain. METHODS This cross-sectional study investigated changes of cortical excitability within left primary motor cortex (M1) by measuring resting motor thresholds, short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), and afferent inhibition between polyneuropathy patients and controls, and investigated the correlates of these parameters with neuropathic pain and the M1 structural and functional connectivity assessed by diffusion tractography imaging and functional MRI. RESULTS Thirty-three painful and 15 non-painful neuropathic patients and 21 controls were enrolled. There were no differences in intraepidermal nerve fiber density, nerve conduction study, thermal thresholds, or autonomic functional tests between patients with and without neuropathic pain. Compared to controls, neuropathic patients exhibited similar resting motor thresholds or afferent inhibition, but attenuated SICI and augmented ICF, especially in painful patients. Changes of intracortical excitability in neuropathic patients were correlated with intensities of neuropathic pain, and different presentations of SICI and ICF were noted between patients with and without thermal paresthesia. Additionally, short latency afferent inhibition at interstimulus intervals of 20 ms was associated with structural connectivity of left M1 with brain areas associated with pain perception. CONCLUSIONS Maladaptive cortical excitability with altered structural connectivity in left M1 developed after peripheral nerve degeneration and was associated with neuropathic pain and sensory symptoms in polyneuropathy.
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Affiliation(s)
- Ming-Chang Chiang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsueh-Wen Hsueh
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ti-Yen Yeh
- Department of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ya-Yin Cheng
- Department of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yi-Hui Kao
- Department of Neurology, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Kai-Chieh Chang
- Department of Neurology, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Fang-Ping Feng
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Chao Chao
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Sung-Tsang Hsieh
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences.,Graduate Institute of Clinical Medicine.,Center of Precision Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
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14
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Qiu J, Du M, Yang J, Lin Z, Qin N, Sun X, Li L, Zou R, Wei J, Wu B, Liu J, Zhang Z. The brain's structural differences between postherpetic neuralgia and lower back pain. Sci Rep 2021; 11:22455. [PMID: 34789811 PMCID: PMC8599674 DOI: 10.1038/s41598-021-01915-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/08/2021] [Indexed: 11/19/2022] Open
Abstract
The purpose is to explore the brain's structural difference in local morphology and between-region networks between two types of peripheral neuropathic pain (PNP): postherpetic neuralgia (PHN) and lower back pain (LBP). A total of 54 participants including 38 LBP and 16 PHN patients were enrolled. The average pain scores were 7.6 and 7.5 for LBP and PHN. High-resolution structural T1 weighted images were obtained. Both grey matter volume (GMV) and morphological connectivity (MC) were extracted. An independent two-sample t-test with false discovery rate (FDR) correction was used to identify the brain regions where LBP and PHN patients showed significant GMV difference. Next, we explored the differences of MC network between LBP and PHN patients and detected the group differences in network properties by using the two-sample t-test and FDR correction. Compared with PHN, LBP patients had significantly larger GMV in temporal gyrus, insula and fusiform gyrus (p < 0.05). The LBP cohort had significantly stronger MC in the connection between right precuneus and left opercular part of inferior frontal gyrus (p < 0.05). LBP patients had significantly stronger degree in left anterior cingulate gyrus and left rectus gyrus (p < 0.05) while had significantly weaker degree than PHN patients in left orbital part of middle frontal gyrus, left supplementary motor area and left superior parietal lobule (p < 0.05). LBP and PHN patients had significant differences in the brain's GMV, MC, and network properties, which implies that different PNPs have different neural mechanisms concerning pain modulation.
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Affiliation(s)
- Jianxing Qiu
- grid.411472.50000 0004 1764 1621Department of Radiology, Peking University First Hospital, 8 XiShiKu Avenue, XiCheng District, Beijing, 100034 China
| | - Mengjiao Du
- grid.263488.30000 0001 0472 9649School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Junzhe Yang
- grid.411472.50000 0004 1764 1621Department of Radiology, Peking University First Hospital, 8 XiShiKu Avenue, XiCheng District, Beijing, 100034 China
| | - Zengmao Lin
- grid.411472.50000 0004 1764 1621Department of Anesthesiology, Peking University First Hospital, Beijing, China
| | - Naishan Qin
- grid.411472.50000 0004 1764 1621Department of Radiology, Peking University First Hospital, 8 XiShiKu Avenue, XiCheng District, Beijing, 100034 China
| | - Xiaowei Sun
- grid.411472.50000 0004 1764 1621Department of Radiology, Peking University First Hospital, 8 XiShiKu Avenue, XiCheng District, Beijing, 100034 China
| | - Linling Li
- grid.263488.30000 0001 0472 9649School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Rushi Zou
- grid.263488.30000 0001 0472 9649School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Juan Wei
- GE Healthcare China, Beijing, China
| | - Bing Wu
- GE Healthcare China, Beijing, China
| | - Jing Liu
- Department of Radiology, Peking University First Hospital, 8 XiShiKu Avenue, XiCheng District, Beijing, 100034, China.
| | - Zhiguo Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China. .,Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen University, Shenzhen, China. .,Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China. .,Peng Cheng Laboratory, Shenzhen, China.
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15
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Abnormal within- and cross-networks functional connectivity in different outcomes of herpes zoster patients. Brain Imaging Behav 2021; 16:366-378. [PMID: 34549378 DOI: 10.1007/s11682-021-00510-y] [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] [Accepted: 07/16/2021] [Indexed: 12/23/2022]
Abstract
Neuroimaging studies have displayed aberrant brain activities in individual sensory- and emotional-linked regions in postherpetic neuralgia (PHN) patients. However, multi-dimensional dysfunction in chronic pain may rely on the interplay between networks. Little is known about the changes in the functional architecture of resting state networks (RSNs) in PHN. In this cross-sectional study, we recruited 31 PHN patients, 33 RHZ patients and 34 HCs; all participants underwent resting-state functional magnetic resonance imaging scans. We investigated the differences of within- and cross-network connectivities between different outcomes of HZ patients [including PHN and recuperation from herpes zoster (RHZ)] and healthy controls (HCs) so as to extract a characteristic network pattern of PHN. The abnormal network connectivities were then correlated with clinical variables in respective groups. PHN and RHZ patients could be similarly characterized by abnormal within-default mode network (DMN), DMN-salience network (SN) and SN-basal ganglia network (BGN) connectivity relative to HCs. Of note, compared with RHZ patients, PHN patients could be characterized by abnormal DMN-BGN and within-BGN connectivity. Furthermore, the within-DMN connectivity was associated with pain-induced emotional scores among PHN patients. Our study presented that network-level imbalance could account for the pain-related dysfunctions in different outcomes of herpes zoster patients. These insights are potentially useful for understanding neuromechanism of PHN and providing central therapeutic targets for PHN.
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16
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Tang Y, Ren C, Wang M, Dai G, Xiao Y, Wang S, Han F, Chen G. Altered gray matter volume and functional connectivity in patients with herpes zoster and postherpetic neuralgia. Brain Res 2021; 1769:147608. [PMID: 34343527 DOI: 10.1016/j.brainres.2021.147608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 06/29/2021] [Accepted: 07/29/2021] [Indexed: 02/08/2023]
Abstract
Numerous neuroimaging studies on postherpetic neuralgia (PHN) and herpes zoster (HZ) have revealed abnormalities in brain structure/microstructure and function. However, few studies have focused on changes in gray matter (GM) volume and intrinsic functional connectivity (FC) in the transition from HZ to PHN. This study combined voxel-based morphometry and FC analysis methods to investigate GM volume and FC differences in 28 PHN patients, 25 HZ patients, and 21 well-matched healthy controls (HCs). Compared to HCs, PHN patients exhibited a reduction in GM volume in the bilateral putamen. Compared with HZ patients, PHN patients showed decreased GM volume in the left parahippocampal gyrus, putamen, anterior cingulate cortex, and right caudate and increased GM volume in the right thalamus. However, no regions with significant GM volume changes were found between the HZ and HC groups. Correlation analysis revealed that GM volume in the right putamen was positively associated with illness duration in PHN patients. Furthermore, lower FCs between the right putamen and right middle frontal gyrus/brainstem were observed in PHN patients than in HCs. These results indicate that aberrant GM volumes and FC in several brain regions, especially in the right putamen, are closely associated with chronification from HZ to PHN; moreover, these changes profoundly affect multiple dimensions of pain processing. These findings may provide new insights into the pathophysiological mechanisms of PHN.
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Affiliation(s)
- Yu Tang
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Changhe Ren
- Department of Pain, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Maohua Wang
- Department of Anesthesiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Guidong Dai
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Yan Xiao
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Fugang Han
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
| | - Guangxiang Chen
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
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17
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Cerritelli F, Chiacchiaretta P, Gambi F, Saggini R, Perrucci MG, Ferretti A. Osteopathy modulates brain-heart interaction in chronic pain patients: an ASL study. Sci Rep 2021; 11:4556. [PMID: 33633195 PMCID: PMC7907192 DOI: 10.1038/s41598-021-83893-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/09/2021] [Indexed: 01/31/2023] Open
Abstract
In this study we used a combination of measures including regional cerebral blood flow (rCBF) and heart rate variability (HRV) to investigate brain-heart correlates of longitudinal baseline changes of chronic low back pain (cLBP) after osteopathic manipulative treatment (OMT). Thirty-two right-handed patients were randomised and divided into 4 weekly session of OMT (N = 16) or Sham (N = 16). Participants aged 42.3 ± 7.3 (M/F: 20/12) with cLBP (duration: 14.6 ± 8.0 m). At the end of the study, patients receiving OMT showed decreased baseline rCBF within several regions belonging to the pain matrix (left posterior insula, left anterior cingulate cortex, left thalamus), sensory regions (left superior parietal lobe), middle frontal lobe and left cuneus. Conversely, rCBF was increased in right anterior insula, bilateral striatum, left posterior cingulate cortex, right prefrontal cortex, left cerebellum and right ventroposterior lateral thalamus in the OMT group as compared with Sham. OMT showed a statistically significant negative correlation between baseline High Frequency HRV changes and rCBF changes at T2 in the left posterior insula and bilateral lentiform nucleus. The same brain regions showed a positive correlation between rCBF changes and Low Frequency HRV baseline changes at T2. These findings suggest that OMT can play a significant role in regulating brain-heart interaction mechanisms.
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Affiliation(s)
- Francesco Cerritelli
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,Clinical-Based Human Research Department, Foundation C.O.ME. Collaboration, Pescara, Italy
| | - Piero Chiacchiaretta
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,grid.412451.70000 0001 2181 4941ITAB-Institute for Advanced Biomedical Technologies, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Francesco Gambi
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,grid.412451.70000 0001 2181 4941ITAB-Institute for Advanced Biomedical Technologies, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Raoul Saggini
- grid.412451.70000 0001 2181 4941School of Specialty in Physical and Rehabilitation Medicine, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Mauro Gianni Perrucci
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,grid.412451.70000 0001 2181 4941ITAB-Institute for Advanced Biomedical Technologies, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Antonio Ferretti
- grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University of Chieti-Pescara, Via dei Vestini, 33, Chieti Scalo, Italy ,grid.412451.70000 0001 2181 4941ITAB-Institute for Advanced Biomedical Technologies, “G. D’Annunzio” University of Chieti-Pescara, Chieti, Italy
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18
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Müller M, Wüthrich F, Federspiel A, Wiest R, Egloff N, Reichenbach S, Exadaktylos A, Jüni P, Curatolo M, Walther S. Altered central pain processing in fibromyalgia-A multimodal neuroimaging case-control study using arterial spin labelling. PLoS One 2021; 16:e0235879. [PMID: 33529254 PMCID: PMC7853499 DOI: 10.1371/journal.pone.0235879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 01/19/2021] [Indexed: 01/12/2023] Open
Abstract
Fibromyalgia is characterized by chronic pain and a striking discrepancy between objective signs of tissue damage and severity of pain. Function and structural alterations in brain areas involved in pain processing may explain this feature. Previous case-control studies in fibromyalgia focused on acute pain processing using experimentally-evoked pain paradigms. Yet, these studies do not allow conclusions about chronic, stimulus-independent pain. Resting-state cerebral blood flow (rsCBF) acquired by arterial spin labelling (ASL) may be a more accurate marker for chronic pain. The objective was to integrate four different functional and structural neuroimaging markers to evaluate the neural correlate of chronic, stimulus-independent pain using a resting-state paradigm. In line with the pathophysiological concept of enhanced central pain processing we hypothesized that rsCBF is increased in fibromyalgia in areas involved in processing of acute pain. We performed an age matched case-control study of 32 female fibromyalgia patients and 32 pain-free controls and calculated group differences in rsCBF, resting state functional connectivity, grey matter volume and cortical thickness using whole-brain and region of interest analyses. We adjusted all analyses for depression and anxiety. As centrally acting drugs are likely to interfere with neuroimaging markers, we performed a subgroup analysis limited to patients not taking such drugs. We found no differences between cases and controls in rsCBF of the thalamus, the basal ganglia, the insula, the somatosensory cortex, the prefrontal cortex, the anterior cingulum and supplementary motor area as brain areas previously identified to be involved in acute processing in fibromyalgia. The results remained robust across all neuroimaging markers and when limiting the study population to patients not taking centrally acting drugs and matched controls. In conclusion, we found no evidence for functional or structural alterations in brain areas involved in acute pain processing in fibromyalgia that could reflect neural correlates of chronic stimulus-independent pain.
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Affiliation(s)
- Monika Müller
- University Clinic of Anesthesiology and Pain Medicine, Inselspital, Bern, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
| | - Florian Wüthrich
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
| | - Roland Wiest
- Department of Neuroradiology, University Clinic of Radiology, Inselspital, Bern, Switzerland
| | - Niklaus Egloff
- Department of Psychosomatic Medicine, University Clinic of Internal Medicine, Inselspital, Bern, Switzerland
| | - Stephan Reichenbach
- University Clinic of Rheumatology, Clinical Immunology and Allergology, Inselspital, Bern, Switzerland
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Peter Jüni
- Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Department of Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Michele Curatolo
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, United States of America
| | - Sebastian Walther
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
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19
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Voxel-Wise Brain-Wide Functional Connectivity Abnormalities in Patients with Primary Blepharospasm at Rest. Neural Plast 2021; 2021:6611703. [PMID: 33505457 PMCID: PMC7808842 DOI: 10.1155/2021/6611703] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 12/12/2022] Open
Abstract
Background Primary blepharospasm (BSP) is one of the most common focal dystonia and its pathophysiological mechanism remains unclear. An unbiased method was used in patients with BSP at rest to observe voxel-wise brain-wide functional connectivity (FC) changes. Method A total of 48 subjects, including 24 untreated patients with BSP and 24 healthy controls, were recruited to undergo functional magnetic resonance imaging (fMRI). The method of global-brain FC (GFC) was adopted to analyze the resting-state fMRI data. We designed the support vector machine (SVM) method to determine whether GFC abnormalities could be utilized to distinguish the patients from the controls. Results Relative to healthy controls, patients with BSP showed significantly decreased GFC in the bilateral superior medial prefrontal cortex/anterior cingulate cortex (MPFC/ACC) and increased GFC in the right postcentral gyrus/precentral gyrus/paracentral lobule, right superior frontal gyrus (SFG), and left paracentral lobule/supplement motor area (SMA), which were included in the default mode network (DMN) and sensorimotor network. SVM analysis showed that increased GFC values in the right postcentral gyrus/precentral gyrus/paracentral lobule could discriminate patients from controls with optimal accuracy, specificity, and sensitivity of 83.33%, 83.33%, and 83.33%, respectively. Conclusion This study suggested that abnormal GFC in the brain areas associated with sensorimotor network and DMN might underlie the pathophysiology of BSP, which provided a new perspective to understand BSP. GFC in the right postcentral gyrus/precentral gyrus/paracentral lobule might be utilized as a latent biomarker to differentiate patients with BSP from controls.
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20
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Deng X, Chau PLH, Chiu SY, Leung KP, Hu Y, Ip WY. Neural plasticity secondary to carpal tunnel syndrome: a pseudo-continuous arterial spin labeling study. Neural Regen Res 2021; 16:158-165. [PMID: 32788471 PMCID: PMC7818880 DOI: 10.4103/1673-5374.286971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Conventional neuroimaging techniques cannot truly reflect the change of regional cerebral blood flow in patients with carpal tunnel syndrome. Pseudo-continuous arterial spinning labeling (pCASL) as an efficient non-invasive neuroimaging technique can be applied to directly quantify the neuronal activities of individual brain regions that show the persistent symptoms owing to its better spatial resolution and increased signal-to-noise ratio. Therefore, this prospective observational study was conducted in 27 eligible female carpal tunnel syndrome, aged 57.7 ± 6.51 years. Psychometric tests, nerve conduction studies and pCASL neuroimaging assessment were performed. The results showed that the relevant activated brain regions in the cortical, subcrotical, and cerebral regions were correlated with numbness, pain, functionality, median nerve status and motor amplitude of median nerve (K = 21-2849, r = -0.77-0.76, P < 0.05). There was a tendency of pain processing which shifted from the nociceptive circuitry to the emotional and cognitive one during the process of chronic pain caused by carpal tunnel syndrome. It suggests the necessity of addressing the ignored cognitive or emotional state when managing patients with carpal tunnel syndrome. Approval for this study was obtained from the Institutional Review Board of The University of Hong Kong/Hospital Authority Hong Kong West, China (HKU/HA HKW IRB, approval No. UW17-129) on April 11, 2017. This study was registered in Clinical Trial Registry of The University of Hong Kong, China (registration number: HKUCTR-2220) on April 24, 2017.
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Affiliation(s)
- Xue Deng
- Department of Orthopedics & Traumatology, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Phoebe Lai-Heung Chau
- Clinical Neuro-diagnostic Unit, Tung Wah Hospital, Hong Kong Special Administrative Region, China
| | - Suk-Yee Chiu
- Clinical Neuro-diagnostic Unit, Tung Wah Hospital, Hong Kong Special Administrative Region, China
| | - Kwok-Pui Leung
- Department of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Yong Hu
- Department of Orthopedics & Traumatology, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Wing-Yuk Ip
- Department of Orthopedics & Traumatology, The University of Hong Kong, Hong Kong Special Administrative Region, China
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Tang Y, Wang M, Zheng T, Xiao Y, Wang S, Han F, Chen G. Structural and functional brain abnormalities in postherpetic neuralgia: A systematic review of neuroimaging studies. Brain Res 2020; 1752:147219. [PMID: 33358730 DOI: 10.1016/j.brainres.2020.147219] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 02/08/2023]
Abstract
In recent decades, an increasing number of neuroimaging studies utilizing magnetic resonance imaging (MRI) have explored the differential effects of postherpetic neuralgia (PHN) on brain structure and function. We systematically reviewed and integrated the findings from relevant neuroimaging studies in PHN patients. A total of 15 studies with 16 datasets were ultimately included in the present study, which were categorized by the different neuroimaging modalities. The results revealed that PHN was closely associated with structural/microstructural and functional abnormalities of the brain mainly located in the 'pain matrix', including the thalamus, insula, parahippocampus, amygdala, dorsolateral prefrontal cortex, precentral gyrus and inferior parietal lobe, as well as other regions, such as the precuneus, lentiform nucleus and brainstem. Furthermore, a disruption of multiple networks, including the default-mode network, salience network and limbic system, may contribute to the neurophysiological mechanisms underlying PHN. The findings indicate that the cerebral abnormalities of PHN were not restricted to the pain matrix but extended to other regions, profoundly affecting the regulation and moderation of pain processing in PHN. Future prospective and longitudinal neuroimaging studies with larger samples will elucidate the progressive trajectory of neural changes in the pathophysiological process of PHN.
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Affiliation(s)
- Yu Tang
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Maohua Wang
- Department of Anesthesiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Ting Zheng
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Yan Xiao
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Fugang Han
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Guangxiang Chen
- Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China.
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Wei Y, Wu L, Wang Y, Liu J, Miao P, Wang K, Wang C, Cheng J. Disrupted Regional Cerebral Blood Flow and Functional Connectivity in Pontine Infarction: A Longitudinal MRI Study. Front Aging Neurosci 2020; 12:577899. [PMID: 33328960 PMCID: PMC7710811 DOI: 10.3389/fnagi.2020.577899] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/12/2020] [Indexed: 11/28/2022] Open
Abstract
Abnormal cerebral blood flow (CBF) and resting-state functional connectivity (rs-FC) are sensitive biomarkers of disease progression and prognosis. This study investigated neural underpinnings of motor and cognitive recovery by longitudinally studying the changes of CBF and FC in pontine infarction (PI). Twenty patients underwent three-dimensional pseudo-continuous arterial spin labeling (3D-pcASL), resting-state functional magnetic resonance imaging (rs-fMRI) scans, and behavioral assessments at 1 week, 1, 3, and 6 months after stroke. Twenty normal control (NC) subjects underwent the same examination once. First, we investigated CBF changes in the acute stage, and longitudinal changes from 1 week to 6 months after PI. Brain regions with longitudinal CBF changes were then used as seeds to investigate longitudinal FC alterations during the follow-up period. Compared with NC, patients in the left PI (LPI) and right PI (RPI) groups showed significant CBF alterations in the bilateral cerebellum and some supratentorial brain regions at the baseline stage. Longitudinal analysis revealed that altered CBF values in the right supramarginal (SMG_R) for the LPI group, while the RPI group showed significantly dynamic changes of CBF in the left calcarine sulcus (CAL_L), middle occipital gyrus (MOG_L), and right supplementary motor area (SMA_R). Using the SMG_R as the seed in the LPI group, FC changes were found in the MOG_L, middle temporal gyrus (MTG_L), and prefrontal lobe (IFG_L). Correlation analysis showed that longitudinal CBF changes in the SMG_R and FC values between the SMG_R and MOG_L were associated with motor and memory scores in the LPI group, and longitudinal CBF changes in the CAL_L and SMA_R were related to memory and motor recovery in the RPI group. These longitudinal CBF and accompany FC alterations may provide insights into the neural mechanism underlying functional recovery after PI, including that of motor and cognitive functions.
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Affiliation(s)
- Ying Wei
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Luobing Wu
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yingying Wang
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingchun Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Peifang Miao
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kaiyu Wang
- GE Healthcare MR Research, Beijing, China
| | - Caihong Wang
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Huang J, Li Y, Xie H, Yang S, Jiang C, Sun W, Li D, Liao Y, Ba X, Xiao L. Abnormal Intrinsic Brain Activity and Neuroimaging-Based fMRI Classification in Patients With Herpes Zoster and Postherpetic Neuralgia. Front Neurol 2020; 11:532110. [PMID: 33192967 PMCID: PMC7642867 DOI: 10.3389/fneur.2020.532110] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 09/01/2020] [Indexed: 01/20/2023] Open
Abstract
Objective: Neuroimaging studies on neuropathic pain have discovered abnormalities in brain structure and function. However, the brain pattern changes from herpes zoster (HZ) to postherpetic neuralgia (PHN) remain unclear. The present study aimed to compare the brain activity between HZ and PHN patients and explore the potential neural mechanisms underlying cognitive impairment in neuropathic pain patients. Methods: Resting-state functional magnetic resonance imaging (MRI) was carried out among 28 right-handed HZ patients, 24 right-handed PHN patients, and 20 healthy controls (HC), using a 3T MRI system. The amplitude of low-frequency fluctuation (ALFF) was analyzed to detect the brain activity of the patients. Correlations between ALFF and clinical pain scales were assessed in two groups of patients. Differences in brain activity between groups were examined and used in a support vector machine (SVM) algorithm for the subjects' classification. Results: Spontaneous brain activity was reduced in both patient groups. Compared with HC, patients from both groups had decreased ALFF in the precuneus, posterior cingulate cortex, and middle temporal gyrus. Meanwhile, the neural activities of angular gyrus and middle frontal gyrus were lowered in HZ and PHN patients, respectively. Reduced ALFF in these regions was associated with clinical pain scales in PHN patients only. Using SVM algorithm, the decreased brain activity in these regions allowed for the classification of neuropathic pain patients (HZ and PHN) and HC. Moreover, HZ and PHN patients are also roughly classified by the same model. Conclusion: Our study indicated that mean ALFF values in these pain-related regions can be used as a functional MRI-based biomarker for the classification of subjects with different pain conditions. Altered brain activity might contribute to PHN-induced pain.
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Affiliation(s)
- Jiabin Huang
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Yongxin Li
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Huijun Xie
- Formula-Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Shaomin Yang
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Changyu Jiang
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Wuping Sun
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Disen Li
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Yuliang Liao
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Xiyuan Ba
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Lizu Xiao
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
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Aberrant resting-state cerebral blood flow and its connectivity in primary dysmenorrhea on arterial spin labeling MRI. Magn Reson Imaging 2020; 73:84-90. [PMID: 32750444 DOI: 10.1016/j.mri.2020.07.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 07/25/2020] [Accepted: 07/30/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to clarify the resting-state cerebral blood flow alteration patterns induced by primary dysmenorrhea, investigate the relationships between cerebral blood flow alterations and clinical parameters of patients with primary dysmenorrhea, and explore whether brain regions with abnormal cerebral blood flow also feature functional connectivity changes. METHODS Arterial spin labeling imaging and clinical parameters were acquired in 42 patients with primary dysmenorrhea and 41 healthy controls during their menstrual phases. Differences in cerebral blood flow were compared between the two groups, and the clusters with significant group differences were selected as the regions of interest for further statistical analyses. RESULTS Compared to healthy controls, patients with primary dysmenorrhea exhibited increased cerebral blood flow in the bilateral precuneus, left posterior cingulate cortex, and right rolandic operculum. Among patients with primary dysmenorrhea, we identified a negative correlation between the cerebral blood flow in the right rolandic operculum and the visual analogue score for anxiety, and greater correlation between the functional connectivity in the precuneus/posterior cingulate cortex and the right middle cingulate cortex, and between the right rolandic operculum and the left inferior parietal lobule and the bilateral postcentral gyrus. DISCUSSION Cerebral blood flow abnormalities associated with primary dysmenorrhea were mainly concentrated in the areas comprising the default mode network in primary dysmenorrhea patients, which could be involved in the central mechanism of primary dysmenorrhea. Cerebral blood flow alteration in the rolandic operculum may underlie an anxiety-induced compulsive tendency in patients with primary dysmenorrhea. Investigating the enhanced connectivity among various pain-related brain regions could improve understanding of the onset and development of primary dysmenorrhea.
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Wu Y, Wang C, Qian W, Yu L, Xing X, Wang L, Sun N, Zhang M, Yan M. Disrupted default mode network dynamics in recuperative patients of herpes zoster pain. CNS Neurosci Ther 2020; 26:1278-1287. [PMID: 32677342 PMCID: PMC7702236 DOI: 10.1111/cns.13433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 06/12/2020] [Accepted: 06/12/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction Previous studies of herpes zoster (HZ) have focused on acute patient manifestations and the most common sequela, postherpetic neuralgia (PHN), both serving to disrupt brain dynamics. Although the majority of such patients gradually recover, without lingering severe pain, little is known about life situations of those who recuperate or the brain dynamics. Our goal was to determine whether default mode network (DMN) dynamics of the recuperative population normalize to the level of healthy individuals. Methods For this purpose, we conducted resting‐state functional magnetic resonance imaging (fMRI) studies in 30 patients recuperating from HZ (RHZ group) and 30 healthy controls (HC group). Independent component analysis (ICA) was initially undertaken in both groups to extract DMN components. DMN spatial maps and within‐DMN functional connectivity were then compared by group and then correlated with clinical variables. Results Relative to controls, DMN spatial maps of recuperating patients showed higher connectivity in middle frontal gyrus (MFG), right/left medial temporal regions of cortex (RMTC/LMTC), right parietal lobe, and parahippocampal gyrus. The RHZ (vs HC) group also demonstrated significant augmentation of within‐DMN connectivity, including that of LMTC‐MFG and LMTC‐posterior cingulate cortex (PCC). Furthermore, the intensity of LMTC‐MFG connectivity correlated significantly with scoring of pain‐induced emotions and life quality. Conclusion Findings of this preliminary study indicate that a disrupted dissociative pattern of DMN persists in patients recuperating from HZ, relative to healthy controls. We have thus provisionally established the brain mechanisms accounting for major outcomes of HZ, offering heuristic cues for future research on HZ transition states.
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Affiliation(s)
- Ying Wu
- Department of Anesthesiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chao Wang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Qian
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lina Yu
- Department of Anesthesiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiufang Xing
- Department of Anesthesiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lieju Wang
- Department of Anesthesiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Na Sun
- Department of Anesthesiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Min Yan
- Department of Anesthesiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Petersen KJ, Garza M, Donahue PM, Harkins KD, Marton A, Titze J, Donahue MJ, Crescenzi R. Neuroimaging of Cerebral Blood Flow and Sodium in Women with Lipedema. Obesity (Silver Spring) 2020; 28:1292-1300. [PMID: 32568462 PMCID: PMC7360333 DOI: 10.1002/oby.22837] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/16/2020] [Accepted: 04/09/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Lipedema is characterized by pain, fatigue, and excessive adipose tissue and sodium accumulation of the lower extremities. This case-control study aims to determine whether sodium or vascular dysfunction is present in the central nervous system. METHODS Brain magnetic resonance imaging was performed at 3 T in patients with lipedema (n = 15) and control (n = 18) participants matched for sex, age, race, and BMI. Standard anatomical imaging and intracranial angiography were applied to evaluate brain volume and vasculopathy, respectively; arterial spin labeling and sodium magnetic resonance imaging were applied to quantify cerebral blood flow (CBF) (milliliters per 100 grams of tissue/minute) and brain tissue sodium content (millimoles per liter), respectively. A Mann-Whitney U test (significance criteria P < 0.05) was applied to evaluate group differences. RESULTS No differences in tissue volume, white matter hyperintensities, intracranial vasculopathy, or tissue sodium content were observed between groups. Gray matter CBF was elevated (P = 0.03) in patients with lipedema (57.2 ± 9.6 mL per 100 g/min) versus control participants (49.8 ± 9.1 mL per 100 g/min). CONCLUSIONS Findings provide evidence that brain sodium and tissue fractions are similar between patients with lipedema and control participants and that patients with lipedema do not exhibit abnormal radiological indicators of intracranial vasculopathy or ischemic injury. Potential explanations for elevated CBF are discussed in the context of the growing literature on lipedema symptomatology and vascular dysfunction.
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Affiliation(s)
- Kalen J. Petersen
- Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville TN, USA
- Corresponding author: Kalen J. Petersen, PhD, Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21 Avenue South, Medical Center North AA-1105B, Nashville, TN 37232, USA, Tel: +1 615.343.7182, Fax: +1 615.322.0734,
| | - Maria Garza
- Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville TN, USA
| | - Paula M.C. Donahue
- Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville TN, USA
- Dayani Center for Health and Wellness, Vanderbilt University School of Medicine, Nashville TN, USA
| | - Kevin D. Harkins
- Biomedical Engineering, Vanderbilt University, Nashville TN, USA
| | - Adriana Marton
- Cardiovascular and Metabolic Disease, Duke-National University of Singapore Medical School
| | - Jens Titze
- Cardiovascular and Metabolic Disease, Duke-National University of Singapore Medical School
| | - Manus J. Donahue
- Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville TN, USA
- Neurology, Vanderbilt University School of Medicine, Nashville, TN, USA
- Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Rachelle Crescenzi
- Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville TN, USA
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The Reorganization of Insular Subregions in Individuals with Below-Level Neuropathic Pain following Incomplete Spinal Cord Injury. Neural Plast 2020; 2020:2796571. [PMID: 32211038 PMCID: PMC7085828 DOI: 10.1155/2020/2796571] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/06/2020] [Accepted: 02/11/2020] [Indexed: 12/12/2022] Open
Abstract
Objective To investigate the reorganization of insular subregions in individuals suffering from neuropathic pain (NP) after incomplete spinal cord injury (ISCI) and further to disclose the underlying mechanism of NP. Method The 3D high-resolution T1-weighted structural images and resting-state functional magnetic resonance imaging (rs-fMRI) of all individuals were obtained using a 3.0 Tesla MRI system. A comparative analysis of structure and function connectivity (FC) with insular subareas as seeds in 10 ISCI individuals with below-level NP (ISCI-P), 11 ISCI individuals without NP (ISCI-N), and 25 healthy controls (HCs) was conducted. Associations between the structural and functional alteration of insula subregions and visual analog scale (VAS) scores were analyzed using the Pearson correlation in SPSS 20. Results Compared with ISCI-N patients, when the left posterior insula as the seed, ISCI-P showed increased FC in right cerebellum VIIb and cerebellum VIII, Brodmann 37 (BA 37). When the left ventral anterior insula as the seed, ISCI-P indicated enhanced FC in right BA18 compared with ISCI-N patients. These increased FCs positively correlated with VAS scores. Relative to HCs, ISCI-P presented increased FC in the left hippocampus when the left dorsal anterior insula was determined as the seed. There was no statistical difference in the volume of insula subregions among the three groups. Conclusion Our study indicated that distinctive patterns of FC in each subregion of insula suggest that the insular subareas participate in the NP processing through different FC following ISCI. Further, insula subregions could serve as a therapeutic target for NP following ISCI.
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Dai H, Jiang C, Wu G, Huang R, Jin X, Zhang Z, Wang L, Li Y. A combined DTI and resting state functional MRI study in patients with postherpetic neuralgia. Jpn J Radiol 2020; 38:440-450. [DOI: 10.1007/s11604-020-00926-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 02/02/2020] [Indexed: 11/29/2022]
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Xu JJ, Cui J, Feng Y, Yong W, Chen H, Chen YC, Yin X, Wu Y. Chronic Tinnitus Exhibits Bidirectional Functional Dysconnectivity in Frontostriatal Circuit. Front Neurosci 2019; 13:1299. [PMID: 31866810 PMCID: PMC6909243 DOI: 10.3389/fnins.2019.01299] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/20/2019] [Indexed: 12/28/2022] Open
Abstract
Purpose The phantom sound of tinnitus is considered to be associated with abnormal functional coupling between the nucleus accumbens (NAc) and the prefrontal cortex, which may form a frontostriatal top-down gating system to evaluate and modulate sensory signals. Resting-state functional magnetic resonance imaging (fMRI) was used to recognize the aberrant directional connectivity of the NAc in chronic tinnitus and to ascertain the relationship between this connectivity and tinnitus characteristics. Methods Participants included chronic tinnitus patients (n = 50) and healthy controls (n = 55), matched for age, sex, education, and hearing thresholds. The hearing status of both groups was comparable. On the basis of the NAc as a seed region, a Granger causality analysis (GCA) study was conducted to investigate the directional connectivity and the relationship with tinnitus duration or distress. Results Compared with healthy controls, tinnitus patients exhibited abnormal directional connectivity between the NAc and the prefrontal cortex, principally the middle frontal gyrus (MFG), orbitofrontal cortex (OFC), and inferior frontal gyrus (IFG). Additionally, positive correlations between tinnitus handicap questionnaire (THQ) scores and increased directional connectivity from the right NAc to the left MFG (r = 0.357, p = 0.015) and from the right MFG to the left NAc (r = 0.626, p < 0.001) were observed. Furthermore, the enhanced directional connectivity from the right NAc to the right OFC was positively associated with the duration of tinnitus (r = 0.599, p < 0.001). Conclusion In concurrence with expectations, tinnitus distress was correlated with enhanced directional connectivity between the NAc and the prefrontal cortex. The current study not only helps illuminate the neural basis of the frontostriatal gating control of tinnitus sensation but also contributes to deciphering the neuropathological features of tinnitus.
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Affiliation(s)
- Jin-Jing Xu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jinluan Cui
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yuan Feng
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Wei Yong
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Huiyou Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yuanqing Wu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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Bao D, Zhou J, Hao Y, Yang X, Jiao W, Hu Y, Wang X. The Effects of Fatiguing Aerobic Exercise on the Cerebral Blood Flow and Oxygen Extraction in the Brain: A Piloting Neuroimaging Study. Front Neurol 2019; 10:654. [PMID: 31293499 PMCID: PMC6598428 DOI: 10.3389/fneur.2019.00654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 06/04/2019] [Indexed: 11/16/2022] Open
Abstract
The fatigue in aerobic exercise affects the task performance. In addition to the fatigue in the muscular system, the diminished performance may arise from the altered cerebral blood supply and oxygen extraction. However, the effects of the fatiguing aerobic exercise on the ability of brain to regulate the cerebral blood flow (CBF) and to extract the oxygen are not fully understood. In this pilot study, we aim to quantify such effects via advanced functional MRI techniques. Twenty healthy younger elite athletes were recruited. In the screening visit, one circle ergometer test was used to screen the maximal relative oxygen consumption (VO2max). Eleven eligible participants then completed the next MRI visit after 7 days. These participants completed a 2-min pulsed arterial spin labeling (ASL) using the PICORE/QUIPSS II and 5-min asymmetric spin echo (ASE) scan at baseline and immediately after the aerobic circle ergometer test. The CBF was then measured using the ASL images and the oxygen consumption of the brain was quantified using oxygen extraction fractions (OEF) derived from the ASE images. The test time, VO2max, and anaerobic threshold were also recorded. As compared to baseline, participants had significant reduction of global CBF (p = 0.003). Specifically, the CBF in bilateral striatum, left middle temporal gyrus (MTG) and right inferior frontal gyrus (IFG) decreased significantly (p < 0.005, K > 20). No significant changes of the OEFs were observed. Participants with greater OEF within the right striatum at baseline had longer test time, greater anaerobic threshold and relative VO2max (r2 > 0.51, p < 0.007). Those with longer test time had less reduction of CBF within the right IFG (r2 = 0.55, p = 0.006) and of OEF within the left striatum (r2 = 0.52, p = 0.008). Additionally, greater anaerobic threshold was associated with less reduction of OEF within the left MTG (r2 = 0.49, p = 0.009). This pilot study provided first-of-its-kind evidence suggesting that the fatiguing aerobic exercise alters the cerebral blood supply in the brain, but has no significant effects on the ability of brain to extract oxygenation. Future studies are warranted to further establish the CBF and OEF as novel markers for physical and physiological function to help the assessment in the sports science and clinics.
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Affiliation(s)
- Dapeng Bao
- Sport Science Research Center, Beijing Sport University, Beijing, China
| | - Junhong Zhou
- The Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Ying Hao
- Peking University, Academy for Advanced Interdisciplinary Studies, Beijing, China
| | - Xuedong Yang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Wei Jiao
- Sport Science Research Center, Beijing Sport University, Beijing, China
| | - Yang Hu
- Sport Science Research Center, Beijing Sport University, Beijing, China
| | - Xiaoying Wang
- Peking University, Academy for Advanced Interdisciplinary Studies, Beijing, China.,Department of Radiology, Peking University First Hospital, Beijing, China
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Abstract
Arterial Spin Labeling (ASL) is a perfusion-based functional magnetic resonance imaging technique that uses water in arterial blood as a freely diffusible tracer to measure regional cerebral blood flow (rCBF) noninvasively. To date its application to the study of pain has been relatively limited. Yet, ASL possesses key features that make it uniquely positioned to study pain in certain paradigms. For instance, ASL is sensitive to very slowly fluctuating brain signals (in the order of minutes or longer). This characteristic makes ASL particularly suitable to the evaluation of brain mechanisms of tonic experimental, post-surgical and ongoing/or continuously varying pain in chronic or acute pain conditions (whereas BOLD fMRI is better suited to detect brain responses to short-lasting or phasic/evoked pain). Unlike positron emission tomography or other perfusion techniques, ASL allows the estimation of rCBF without requiring the administration of radioligands or contrast agents. Thus, ASL is well suited for within-subject longitudinal designs (e.g., to study evolution of pain states over time, or of treatment effects in clinical trials). ASL is also highly versatile, allowing for novel paradigms exploring a flexible array of pain states, plus it can be used to simultaneously estimate not only pain-related alterations in perfusion but also functional connectivity. In conclusion, ASL can be successfully applied in pain paradigms that would be either challenging or impossible to implement using other techniques. Particularly when used in concert with other neuroimaging techniques, ASL can be a powerful tool in the pain imager's toolbox.
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Zeng P, Huang J, Wu S, Qian C, Chen F, Sun W, Tao W, Liao Y, Zhang J, Yang Z, Zhong S, Zhang Z, Xiao L, Huang B. Characterizing the Structural Pattern Predicting Medication Response in Herpes Zoster Patients Using Multivoxel Pattern Analysis. Front Neurosci 2019; 13:534. [PMID: 31191228 PMCID: PMC6546876 DOI: 10.3389/fnins.2019.00534] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/08/2019] [Indexed: 12/29/2022] Open
Abstract
Herpes zoster (HZ) can cause a blistering skin rash with severe neuropathic pain. Pharmacotherapy is the most common treatment for HZ patients. However, most patients are usually the elderly or those that are immunocompromised, and thus often suffer from side effects or easily get intractable post-herpetic neuralgia (PHN) if medication fails. It is challenging for clinicians to tailor treatment to patients, due to the lack of prognosis information on the neurological pathogenesis that underlies HZ. In the current study, we aimed at characterizing the brain structural pattern of HZ before treatment with medication that could help predict medication responses. High-resolution structural magnetic resonance imaging (MRI) scans of 14 right-handed HZ patients (aged 61.0 ± 7.0, 8 males) with poor response and 15 (aged 62.6 ± 8.3, 5 males) age- (p = 0.58), gender-matched (p = 0.20) patients responding well, were acquired and analyzed. Multivoxel pattern analysis (MVPA) with a searchlight algorithm and support vector machine (SVM), was applied to identify the spatial pattern of the gray matter (GM) volume, with high predicting accuracy. The predictive regions, with an accuracy higher than 79%, were located within the cerebellum, posterior insular cortex (pIC), middle and orbital frontal lobes (mFC and OFC), anterior and middle cingulum (ACC and MCC), precuneus (PCu) and cuneus. Among these regions, mFC, pIC and MCC displayed significant increases of GM volumes in patients with poor response, compared to those with a good response. The combination of sMRI and MVPA might be a useful tool to explore the neuroanatomical imaging biomarkers of HZ-related pain associated with medication responses.
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Affiliation(s)
- Ping Zeng
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Clinical Research Center for Neurological Diseases, Shenzhen University, Shenzhen, China
| | - Jiabin Huang
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen Sixth Hospital of Guangdong Medical University, Shenzhen, China
| | - Songxiong Wu
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Clinical Research Center for Neurological Diseases, Shenzhen University, Shenzhen, China
| | - Chengrui Qian
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen Sixth Hospital of Guangdong Medical University, Shenzhen, China
| | - Fuyong Chen
- Clinical Research Center for Neurological Diseases, Shenzhen University, Shenzhen, China.,Department of Neurosurgery, Shenzhen University General Hospital, Shenzhen, China
| | - Wuping Sun
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen Sixth Hospital of Guangdong Medical University, Shenzhen, China
| | - Wei Tao
- Clinical Research Center for Neurological Diseases, Shenzhen University, Shenzhen, China.,Department of Neurosurgery, Shenzhen University General Hospital, Shenzhen, China
| | - Yuliang Liao
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen Sixth Hospital of Guangdong Medical University, Shenzhen, China
| | - Jianing Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Clinical Research Center for Neurological Diseases, Shenzhen University, Shenzhen, China
| | - Zefan Yang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Clinical Research Center for Neurological Diseases, Shenzhen University, Shenzhen, China
| | - Shaonan Zhong
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Clinical Research Center for Neurological Diseases, Shenzhen University, Shenzhen, China
| | - Zhiguo Zhang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Lizu Xiao
- Department of Pain Medicine and Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen Sixth Hospital of Guangdong Medical University, Shenzhen, China
| | - Bingsheng Huang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Clinical Research Center for Neurological Diseases, Shenzhen University, Shenzhen, China
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Liu J, Gu L, Huang Q, Hong S, Zeng X, Zhang D, Zhou F, Jiang J. Altered gray matter volume in patients with herpes zoster and postherpetic neuralgia. J Pain Res 2019; 12:605-616. [PMID: 30799946 PMCID: PMC6369852 DOI: 10.2147/jpr.s183561] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose The aim of this study was to measure brain alterations in patients with herpes zoster (HZ) and postherpetic neuralgia (PHN) and compare their differences using a voxel-based morphometry (VBM) technique. Materials and methods Thirty-three patients with HZ, 22 patients with PHN, and 28 well-matched healthy controls (HCs) were recruited. Magnetic resonance imaging data were acquired for all subjects and analyzed using the VBM method. The changes in gray matter volume (GMV) in HZ and PHN groups were compared with those in HC group, and the GMV differences were also compared between the PHN and HZ groups. Further correlation analysis and receiver operating characteristic curves were used to confirm the significance of GMV changes in various brain regions. Results Compared with HCs, decreased GMV was found in the bilateral insular lobes and increased GMV was found in the bilateral thalamus in the HZ group. In the PHN group, GMV decreased in the bilateral insula lobes, right middle frontal gyrus, bilateral precentral gyrus, and left postcentral gyrus and increased in the left cerebellar posterior lobe, right parahippocampal gyrus, and right lentiform nucleus. In addition, the PHN group exhibited increased GMV in the left cerebellar tonsil, culmen, and left lentiform nucleus and decreased GMV in the right precentral gyrus compared with the HZ group. Further correlation analysis and receiver operating characteristic curves revalidate the significance of most of these abnormal brain regions. Conclusion The VBM method revealed widespread GMV abnormalities in HZ and PHN patients. The brains of PHN patients have broader abnormalities in nonpain-related regions, suggesting the complexity of a central mechanism. When PHN patients were compared with HZ patients, the left cerebellar tonsil, culmen, and left lentiform nucleus corresponded to greater area under the curve, suggesting that abnormalities in these regions are risk factors for HZ patients’ transformation to PHN.
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Affiliation(s)
| | - Lili Gu
- Department of Pain, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | | | | | | | - Daying Zhang
- Department of Pain, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
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Gu L, Hong S, Jiang J, Liu J, Cao X, Huang Q, Zeng X, Zhou F, Zhang D. Bidirectional alterations in ALFF across slow-5 and slow-4 frequencies in the brains of postherpetic neuralgia patients. J Pain Res 2018; 12:39-47. [PMID: 30588078 PMCID: PMC6302822 DOI: 10.2147/jpr.s179077] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Postherpetic neuralgia (PHN) detrimentally affects brain function. Recent studies have suggested that frequency-dependent changes in electroencephalography in chronic pain patients and blood oxygenation level dependent (BOLD) fluctuations can reflect neuronal activity in different frequencies. The current study aimed to investigate PHN-related brain oscillatory activity in a specific frequency band by using the amplitude of low-frequency fluctuation (ALFF) method. MATERIALS AND METHODS ALFF changes were analyzed across different frequencies (slow-4 band: 0.027-0.073 Hz; slow-5 band: 0.01-0.027 Hz; and typical band: 0.01-0.08 Hz) in the brains of PHN patients and compared with those in the brains of healthy controls (HCs) during resting-state fMRI. Eighteen HCs and PHN patients underwent fMRI scanning. RESULTS In the typical band, compared with HCs, PHN patients showed prominently decreased ALFF in the right prefrontal cortex (Brodmann area 10/46) and increased ALFF in the bilateral brain stem/cerebellum anterior lobe (BS/CAL). In the slow-4 band, PHN patients exhibited significantly decreased ALFF in the bilateral cuneus/lingual gyrus and the right prefrontal cortex. In the slow-5 band, PHN patients presented significantly increased ALFF in the bilateral BS/CAL and left parieto-occipital cortex. Moreover, the increased ALFF in the left parieto-occipital cortex in the slow-5 band was positively correlated with VAS scores (P=0.022), and the increased ALFF in the bilateral BS/CAL in the slow-5 band was positively correlated with disease duration (P=0.020). CONCLUSION Our results suggested that the intrinsic brain activity of PHN patients was abnormal and frequency dependent, especially the bidirectional alteration in ALFF across the slow-4 and slow-5 frequencies in the brains of PHN patients.
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Affiliation(s)
- Lili Gu
- Department of Pain, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China,
| | - Shunda Hong
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China,
| | - Jian Jiang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China,
| | - Jiaqi Liu
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China,
| | - Xintian Cao
- Department of Pain, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China,
| | - Qing Huang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China,
| | - Xianjun Zeng
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China,
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China,
| | - Daying Zhang
- Department of Pain, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China,
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Liu J, Zhang F, Liu X, Zhuo Z, Wei J, Du M, Chan Q, Wang X, Wang D. Altered small-world, functional brain networks in patients with lower back pain. SCIENCE CHINA-LIFE SCIENCES 2018; 61:1420-1424. [PMID: 30417246 DOI: 10.1007/s11427-017-9108-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 08/15/2018] [Indexed: 02/08/2023]
Abstract
In this study, we aimed to investigate the functional network changes that occur in patients with lower back pain (LBP). We also investigated the link between LBP and the small-world properties of functional networks within the brain. Functional MRI (fMRI) was performed on 20 individuals with LBP and 17 age and gender-matched normal controls during the resting state. The severity of the pain in the individuals with LBP ranged from 5 to 8 on a 0-10 scale, with 0 indicating no pain. Network-based statistics were performed to investigate the differences between the brain networks of individuals with LBP and those of normal controls. Several small-world parameters of brain networks were calculated, including the clustering coefficient, characteristic path length, local efficiency, and global efficiency. These criteria reflect the overall network efficiency. The brain networks in the individuals with LBP due to herniation of a lumbar disc demonstrated a significantly longer characteristic path length as well as a lower clustering coefficient, global efficiency, and local efficiency compared to those in control subjects. We found that LBP patients tended to have unstable and inefficient brain networks when compared with healthy controls. In addition, LBP individuals showed significantly decreased functional connectivity in the anterior cingulate cortex, middle cingulate cortex, post cingulate cortex, inferior frontal gyrus, middle temporal gyrus, occipital gyrus, postcentral gyrus, precentral gyrus, supplementary motor area, thalamus, fusiform, caudate, and cerebellum. We believe that these regions may be involved in the pathophysiology of lower back pain.
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Affiliation(s)
- Jing Liu
- Department of Radiology, Peking University First Hospital, Beijing, 100034, China
| | - Feng Zhang
- Department of Anesthesiology, Peking University First Hospital, Beijing, 100034, China
| | - Xiufen Liu
- Department of Anesthesiology, Peking University First Hospital, Beijing, 100034, China
| | | | - Juan Wei
- Philips Research China, Shanghai, 200040, China
| | - Minyi Du
- Department of Anesthesiology, Peking University First Hospital, Beijing, 100034, China
| | | | - Xiaoying Wang
- Department of Radiology, Peking University First Hospital, Beijing, 100034, China.
| | - Dongxin Wang
- Department of Anesthesiology, Peking University First Hospital, Beijing, 100034, China.
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Li J, Huang X, Sang K, Bodner M, Ma K, Dong XW. Modulation of prefrontal connectivity in postherpetic neuralgia patients with chronic pain: a resting-state functional magnetic resonance-imaging study. J Pain Res 2018; 11:2131-2144. [PMID: 30323648 PMCID: PMC6174681 DOI: 10.2147/jpr.s166571] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background Although the interaction between pain and cognition has been recognized for decades, the neural substrates underlying their association remain unclear. The prefrontal cortex (PFC) is known as a critical brain area for higher cognitive functions, as well as for pain perception and modulation. The objective of the present study was to explore the role of the PFC in the interaction between chronic pain and cognitive functions by examining the relationship between spontaneous activity in the frontal lobe and pain intensity reported by postherpetic neuralgia (PHN) patients. Methods Resting-state functional magnetic resonance imaging data from 16 PHN patients were collected, and regional homogeneity and related functional connectivity were analyzed. Results The results showed negative correlations between patients’ pain scores and regional homogeneity values in several prefrontal areas, including the left lateral PFC, left medial PFC, and right lateral orbitofrontal cortex (P<0.05, AlphaSim-corrected). Further analysis revealed that the functional connectivity of some of these prefrontal areas with other cortical regions was also modulated by pain intensity. Therefore, functional connections of the left lateral PFC with both the left parietal cortex and the left occipital cortex were correlated with patients’ pain ratings (P<0.05, AlphaSim-corrected). Similarly, functional connectivity between the right lateral orbitofrontal cortex and bilateral postcentral/precentral gyri was also correlated with pain intensity in the patients (P<0.05, AlphaSim-corrected). Conclusion Our findings indicate that activity in the PFC is modulated by chronic pain in PHN patients. The pain-related modulation of prefrontal activity may serve as the neural basis for interactions between chronic pain and cognitive functions, which may link to cognitive impairments observed in chronic pain patients.
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Affiliation(s)
- Jun Li
- Key Laboratory of Brain Functional Genomics (MOE and STCSM), Shanghai Changning ECNU Mental Health Center, Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China,
| | - Xuehua Huang
- Department of Pain Management, Xin Hua Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China,
| | - Kangning Sang
- Key Laboratory of Brain Functional Genomics (MOE and STCSM), Shanghai Changning ECNU Mental Health Center, Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China,
| | | | - Ke Ma
- Department of Pain Management, Xin Hua Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China,
| | - Xiao-Wei Dong
- Key Laboratory of Brain Functional Genomics (MOE and STCSM), Shanghai Changning ECNU Mental Health Center, Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China, .,NYU-ECNU Institute of Brain and Cognitive Science, NYU Shanghai, Shanghai, China,
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Hong S, Gu L, Zhou F, Liu J, Huang M, Jiang J, He L, Gong H, Zeng X. Altered functional connectivity density in patients with herpes zoster and postherpetic neuralgia. J Pain Res 2018; 11:881-888. [PMID: 29740216 PMCID: PMC5931198 DOI: 10.2147/jpr.s154314] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose The aim of this study was to explore intrinsic functional connectivity patterns in patients with herpes zoster (HZ) and postherpetic neuralgia (PHN). Patients and methods Thirty-three right-handed HZ patients (13 males; mean age 57.15±9.30 years), 22 right-handed PHN patients (9 males; mean age 66.13±6.77 years), and 28 well-matched healthy controls (HC) (9 males; mean age 54.21±7.72 years) underwent resting-state functional magnetic resonance imaging for intrinsic functional connectivity analyses. Functional connectivity density (FCD) was calculated and compared among the PHN, HZ, and HC groups. In addition, the Pearson correlation coefficient was calculated to compare various clinical indices in the regions with abnormal FCD values. Results Compared with the HC, both HZ and PHN patients showed significantly decreased FCD in the precuneus, and patients with HZ displayed significantly increased FCD in the brainstem/limbic lobe/parahippocampalgyrus, whereas patients with PHN displayed significantly increased FCD in the hippocampus (correlation thresholds r=0.25, voxel level of P<0.01 and Gaussian random field theory at a cluster level of P<0.05). However, the FCD was not significantly different between the PHN and HZ patients. Furthermore, the decreased FCD in the precuneus was positively correlated with the visual analog scale score in the PHN group (r=0.672; P=0.001). Conclusion Decreased connectivity of the precuneus occurred in both HZ and PHN patients, indicating a disrupted default-mode network. Furthermore, in the HZ group (initial stage of the virus infection), hyperconnectivity was observed in systems involved in pain transmission and interpretation, but hyperconnectivity only occurred in the hippocampus in the PHN group (neuropathic pain stage).
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Affiliation(s)
- Shunda Hong
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Lili Gu
- Department of Pain, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Jiaqi Liu
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Muhua Huang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Jian Jiang
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Laichang He
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Xianjun Zeng
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
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Altered functional connectivity of the periaqueductal gray in chronic neck and shoulder pain. Neuroreport 2018; 28:720-725. [PMID: 28574927 DOI: 10.1097/wnr.0000000000000819] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Chronic neck and shoulder pain with cervical spondylotic radiculopathy (CNSP-CSR) is one of the most common clinical chronic pain diseases. This study aimed to investigate the abnormal patterns in functional connectivity (FC) pertaining to the periaqueductal gray matter (PAG) in patients with CNSP-CSR. A seed-based FC analysis was carried out for the right ventrolateral PAG and a correlation analysis was carried out with pain intensity, duration, and the extracted mean z scores. The PAG FC was significantly positively associated with the right orbital inferior frontal gyrus, supramarginal gyrus/postcentral gyrus, putamen, and the left anterior cingulate cortex, and significant negative FC was observed in the right lingual gyrus/occipital cortex in patients with CNSP-CSR. A significant negative correlation was found between the pain intensity and the mean z scores in the left anterior cingulate cortex. Our study provides evidence to show that patients with CNSP-CSR have abnormal FC in the PAG-centered pain modulation network. Knowledge of this abnormal FC might lead to a better understanding of the mechanism underlying CNSP-CSR, especially the descending pain modulation system involved in chronic pain.
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Chang WJ, O'Connell NE, Beckenkamp PR, Alhassani G, Liston MB, Schabrun SM. Altered Primary Motor Cortex Structure, Organization, and Function in Chronic Pain: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2018; 19:341-359. [DOI: 10.1016/j.jpain.2017.10.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/15/2017] [Accepted: 10/19/2017] [Indexed: 01/14/2023]
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Shokouhi M, Clarke C, Morley-Forster P, Moulin DE, Davis KD, St. Lawrence K. Structural and Functional Brain Changes at Early and Late Stages of Complex Regional Pain Syndrome. THE JOURNAL OF PAIN 2018; 19:146-157. [DOI: 10.1016/j.jpain.2017.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 09/12/2017] [Accepted: 09/30/2017] [Indexed: 01/21/2023]
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Neitzel J, Nuttall R, Sorg C. Perspectives on How Human Simultaneous Multi-Modal Imaging Adds Directionality to Spread Models of Alzheimer's Disease. Front Neurol 2018; 9:26. [PMID: 29434570 PMCID: PMC5790782 DOI: 10.3389/fneur.2018.00026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 01/12/2018] [Indexed: 12/31/2022] Open
Abstract
Previous animal research suggests that the spread of pathological agents in Alzheimer’s disease (AD) follows the direction of signaling pathways. Specifically, tau pathology has been suggested to propagate in an infection-like mode along axons, from transentorhinal cortices to medial temporal lobe cortices and consequently to other cortical regions, while amyloid-beta (Aβ) pathology seems to spread in an activity-dependent manner among and from isocortical regions into limbic and then subcortical regions. These directed connectivity-based spread models, however, have not been tested directly in AD patients due to the lack of an in vivo method to identify directed connectivity in humans. Recently, a new method—metabolic connectivity mapping (MCM)—has been developed and validated in healthy participants that uses simultaneous FDG-PET and resting-state fMRI data acquisition to identify directed intrinsic effective connectivity (EC). To this end, postsynaptic energy consumption (FDG-PET) is used to identify regions with afferent input from other functionally connected brain regions (resting-state fMRI). Here, we discuss how this multi-modal imaging approach allows quantitative, whole-brain mapping of signaling direction in AD patients, thereby pointing out some of the advantages it offers compared to other EC methods (i.e., Granger causality, dynamic causal modeling, Bayesian networks). Most importantly, MCM provides the basis on which models of pathology spread, derived from animal studies, can be tested in AD patients. In particular, future work should investigate whether tau and Aβ in humans propagate along the trajectories of directed connectivity in order to advance our understanding of the neuropathological mechanisms causing disease progression.
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Affiliation(s)
- Julia Neitzel
- Department of General and Experimental Psychology, Ludwig-Maximilians-Universität (LMU), München, Germany.,TUM-Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technische Universität München (TUM), München, Germany
| | - Rachel Nuttall
- TUM-Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technische Universität München (TUM), München, Germany.,Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München (TUM), München, Germany
| | - Christian Sorg
- TUM-Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technische Universität München (TUM), München, Germany.,Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München (TUM), München, Germany.,Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München (TUM), München, Germany
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Bosch OG, Esposito F, Havranek MM, Dornbierer D, von Rotz R, Staempfli P, Quednow BB, Seifritz E. Gamma-Hydroxybutyrate Increases Resting-State Limbic Perfusion and Body and Emotion Awareness in Humans. Neuropsychopharmacology 2017; 42:2141-2151. [PMID: 28561068 PMCID: PMC5603804 DOI: 10.1038/npp.2017.110] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/04/2017] [Accepted: 05/25/2017] [Indexed: 12/15/2022]
Abstract
Gamma-hydroxybutyrate (GHB) is a GHB-/GABA-B receptor agonist inducing a broad spectrum of subjective effects including euphoria, disinhibition, and enhanced vitality. It is used as treatment for neuropsychiatric disorders including narcolepsy and alcohol withdrawal, but is also a drug of abuse. Non-medical users report enhancement of body and emotion awareness during intoxication. However, the neuronal underpinnings of such awareness alterations under GHB are unknown so far. The assessment of regional cerebral blood flow (rCBF) by pharmacological magnetic resonance imaging (phMRI) enables the elucidation of drug-induced functional brain alterations. Thus, we assessed the effects of GHB (35 mg/kg p.o.) in 17 healthy males on rCBF and subjective drug effects, using a placebo-controlled, double-blind, randomized, cross-over design employing arterial spin labeling phMRI. Compared to placebo, GHB increased subjective ratings for body and emotion awareness, and for dizziness (p<0.01-0.001, Bonferroni-corrected). A whole-brain analysis showed increased rCBF in the bilateral anterior cingulate cortex (ACC) and the right anterior insula under GHB (p<0.05, cluster-corrected). ACC and insula rCBF are correlated with relaxation, and body and emotion awareness (p<0.05-0.001, uncorrected). Interaction analyses revealed that GHB-induced increase of body awareness was accompanied by increased rCBF in ACC, whereas relaxation under GHB was accompanied by elevated rCBF in right anterior insula (p<0.05, uncorrected). In conclusion, enhancement of emotion and body awareness, and increased perfusion of insula and ACC bears implications both for the properties of GHB as a drug of abuse as well as for its putative personalized potential for specific therapeutic indications in affective disorders.
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Affiliation(s)
- Oliver G Bosch
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland,Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland,Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, Zurich CH-8032, Switzerland, Tel: +41 44 384 2357, Fax: +41 44 383 4456, E-mail:
| | - Fabrizio Esposito
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Baronissi, Italy
| | - Michael M Havranek
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Dario Dornbierer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland,Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Robin von Rotz
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Philipp Staempfli
- MR-Center of the Department of Psychiatry, Psychotherapy and Psychosomatics and the Department of Child and Adolescent Psychiatry, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland,Neuroscience Center Zurich, Research Group Disorders of the Nervous System, University and ETH Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland,Neuroscience Center Zurich, Research Group Disorders of the Nervous System, University and ETH Zurich, Zurich, Switzerland
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Lin Y, Bai Y, Liu P, Yang X, Qin W, Gu J, Ding D, Tian J, Wang M. Alterations in regional homogeneity of resting-state cerebral activity in patients with chronic prostatitis/chronic pelvic pain syndrome. PLoS One 2017; 12:e0184896. [PMID: 28926645 PMCID: PMC5605002 DOI: 10.1371/journal.pone.0184896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/01/2017] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study was to explore the neural mechanism in Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS) using resting-state functional magnetic resonance imaging. The functional magnetic resonance imaging was performed on 31 male CP/CPPS-patients and 31 age and education matched male healthy controls on a 3-T magnetic resonance imaging unit. A two-sample t-test was adopted to reveal the regional homogeneity between the patients and healthy controls. The mean regional homogeneity values in the alerted brain regions of patients were correlated with the clinical measurements by using Pearson's correlation analyses. The CP/CPPS-patients had significantly decreased regional homogeneity in the bilateral anterior cingulate cortices, insular cortices and right medial prefrontal cortex, while significantly increased regional homogeneity in the brainstem and right thalamus compared with the healthy controls. In the CP/CPPS-patients, the mean regional homogeneity value in the left anterior cingulate cortex, bilateral insular cortices and brainstem were respectively correlated with the National Institutes of Health Chronic Prostatitis Symptom Index total score and pain subscale. These brain regions are important in the pain modulation process. Therefore, an impaired pain modulatory system, either by decreased descending pain inhibition or enhanced pain facilitation, may explain the pain symptoms in CP/CPPS.
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Affiliation(s)
- Yusong Lin
- The Cooperative Innovation Center of Internet Healthcare & School of Software and Applied Technology, Zhengzhou University, Zhengzhou, China
| | - Yan Bai
- Department of Radiology, Zhengzhou University People’s Hospital & Henan Provincial People's Hospital, Zhengzhou, China
- Henan Key Laboratory for Medical Imaging of Neurological Disease, China
- Medical School, Henan University, Zhengzhou, China
| | - Peng Liu
- School of Life Sciences and Technology, Xidian University, Xian, China
| | - Xuejuan Yang
- School of Life Sciences and Technology, Xidian University, Xian, China
| | - Wei Qin
- School of Life Sciences and Technology, Xidian University, Xian, China
| | - Jianqin Gu
- Henan Provincial Clinical Big Data Analysis and Service Engineering Research Center, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
| | - Degang Ding
- Department of Urology, Zhengzhou University People’s Hospital & Henan Provincial People's Hospital, Zhengzhou, China
- * E-mail: (MW); (JT); (DD)
| | - Jie Tian
- Institute of Automation, Chinese Academy of Sciences, Beijing, China
- * E-mail: (MW); (JT); (DD)
| | - Meiyun Wang
- Department of Radiology, Zhengzhou University People’s Hospital & Henan Provincial People's Hospital, Zhengzhou, China
- Henan Key Laboratory for Medical Imaging of Neurological Disease, China
- Medical School, Henan University, Zhengzhou, China
- Henan Provincial Clinical Big Data Analysis and Service Engineering Research Center, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Zhengzhou, China
- * E-mail: (MW); (JT); (DD)
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Chen F, Chen F, Shang Z, Shui Y, Wu G, Liu C, Lin Z, Lin Y, Yu L, Kang D, Tao W, Li Y. White matter microstructure degenerates in patients with postherpetic neuralgia. Neurosci Lett 2017; 656:152-157. [DOI: 10.1016/j.neulet.2017.07.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 07/05/2017] [Accepted: 07/14/2017] [Indexed: 11/30/2022]
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Haller S, Zaharchuk G, Thomas DL, Lovblad KO, Barkhof F, Golay X. Arterial Spin Labeling Perfusion of the Brain: Emerging Clinical Applications. Radiology 2017; 281:337-356. [PMID: 27755938 DOI: 10.1148/radiol.2016150789] [Citation(s) in RCA: 329] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Arterial spin labeling (ASL) is a magnetic resonance (MR) imaging technique used to assess cerebral blood flow noninvasively by magnetically labeling inflowing blood. In this article, the main labeling techniques, notably pulsed and pseudocontinuous ASL, as well as emerging clinical applications will be reviewed. In dementia, the pattern of hypoperfusion on ASL images closely matches the established patterns of hypometabolism on fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) images due to the close coupling of perfusion and metabolism in the brain. This suggests that ASL might be considered as an alternative for FDG, reserving PET to be used for the molecular disease-specific amyloid and tau tracers. In stroke, ASL can be used to assess perfusion alterations both in the acute and the chronic phase. In arteriovenous malformations and dural arteriovenous fistulas, ASL is very sensitive to detect even small degrees of shunting. In epilepsy, ASL can be used to assess the epileptogenic focus, both in peri- and interictal period. In neoplasms, ASL is of particular interest in cases in which gadolinium-based perfusion is contraindicated (eg, allergy, renal impairment) and holds promise in differentiating tumor progression from benign causes of enhancement. Finally, various neurologic and psychiatric diseases including mild traumatic brain injury or posttraumatic stress disorder display alterations on ASL images in the absence of visualized structural changes. In the final part, current limitations and future developments of ASL techniques to improve clinical applicability, such as multiple inversion time ASL sequences to assess alterations of transit time, reproducibility and quantification of cerebral blood flow, and to measure cerebrovascular reserve, will be reviewed. © RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Sven Haller
- From Affidea Centre Diagnostique Radiologique de Carouge, Clos de la Fonderie 1, 1227 Carouge, Switzerland (S.H.); Dept of Surgical Sciences, Div of Radiology, Uppsala Univ, Sweden (S.H.); Dept of Neuroradiology, Univ Hosp Freiburg, Germany (S.H.); Faculty of Medicine Univ of Geneva, Switzerland (S.H.); Dept of Radiology, Stanford Univ, Stanford, Calif (G.Z.); Univ College London, Inst of Neurology, London, England (D.L.T., X.G.); Dept of Diagnostic and Interventional Neuroradiology, Geneva Univ Hosps,Switzerland (K.O.L.); Dept of Radiology & Nuclear Medicine and PET Research, VU Univ Medical Ctr, Amsterdam, the Netherlands (F.B.); and Insts of Neurology and Healthcare Engineering, Univ College London, England (F.B.)
| | - Greg Zaharchuk
- From Affidea Centre Diagnostique Radiologique de Carouge, Clos de la Fonderie 1, 1227 Carouge, Switzerland (S.H.); Dept of Surgical Sciences, Div of Radiology, Uppsala Univ, Sweden (S.H.); Dept of Neuroradiology, Univ Hosp Freiburg, Germany (S.H.); Faculty of Medicine Univ of Geneva, Switzerland (S.H.); Dept of Radiology, Stanford Univ, Stanford, Calif (G.Z.); Univ College London, Inst of Neurology, London, England (D.L.T., X.G.); Dept of Diagnostic and Interventional Neuroradiology, Geneva Univ Hosps,Switzerland (K.O.L.); Dept of Radiology & Nuclear Medicine and PET Research, VU Univ Medical Ctr, Amsterdam, the Netherlands (F.B.); and Insts of Neurology and Healthcare Engineering, Univ College London, England (F.B.)
| | - David L Thomas
- From Affidea Centre Diagnostique Radiologique de Carouge, Clos de la Fonderie 1, 1227 Carouge, Switzerland (S.H.); Dept of Surgical Sciences, Div of Radiology, Uppsala Univ, Sweden (S.H.); Dept of Neuroradiology, Univ Hosp Freiburg, Germany (S.H.); Faculty of Medicine Univ of Geneva, Switzerland (S.H.); Dept of Radiology, Stanford Univ, Stanford, Calif (G.Z.); Univ College London, Inst of Neurology, London, England (D.L.T., X.G.); Dept of Diagnostic and Interventional Neuroradiology, Geneva Univ Hosps,Switzerland (K.O.L.); Dept of Radiology & Nuclear Medicine and PET Research, VU Univ Medical Ctr, Amsterdam, the Netherlands (F.B.); and Insts of Neurology and Healthcare Engineering, Univ College London, England (F.B.)
| | - Karl-Olof Lovblad
- From Affidea Centre Diagnostique Radiologique de Carouge, Clos de la Fonderie 1, 1227 Carouge, Switzerland (S.H.); Dept of Surgical Sciences, Div of Radiology, Uppsala Univ, Sweden (S.H.); Dept of Neuroradiology, Univ Hosp Freiburg, Germany (S.H.); Faculty of Medicine Univ of Geneva, Switzerland (S.H.); Dept of Radiology, Stanford Univ, Stanford, Calif (G.Z.); Univ College London, Inst of Neurology, London, England (D.L.T., X.G.); Dept of Diagnostic and Interventional Neuroradiology, Geneva Univ Hosps,Switzerland (K.O.L.); Dept of Radiology & Nuclear Medicine and PET Research, VU Univ Medical Ctr, Amsterdam, the Netherlands (F.B.); and Insts of Neurology and Healthcare Engineering, Univ College London, England (F.B.)
| | - Frederik Barkhof
- From Affidea Centre Diagnostique Radiologique de Carouge, Clos de la Fonderie 1, 1227 Carouge, Switzerland (S.H.); Dept of Surgical Sciences, Div of Radiology, Uppsala Univ, Sweden (S.H.); Dept of Neuroradiology, Univ Hosp Freiburg, Germany (S.H.); Faculty of Medicine Univ of Geneva, Switzerland (S.H.); Dept of Radiology, Stanford Univ, Stanford, Calif (G.Z.); Univ College London, Inst of Neurology, London, England (D.L.T., X.G.); Dept of Diagnostic and Interventional Neuroradiology, Geneva Univ Hosps,Switzerland (K.O.L.); Dept of Radiology & Nuclear Medicine and PET Research, VU Univ Medical Ctr, Amsterdam, the Netherlands (F.B.); and Insts of Neurology and Healthcare Engineering, Univ College London, England (F.B.)
| | - Xavier Golay
- From Affidea Centre Diagnostique Radiologique de Carouge, Clos de la Fonderie 1, 1227 Carouge, Switzerland (S.H.); Dept of Surgical Sciences, Div of Radiology, Uppsala Univ, Sweden (S.H.); Dept of Neuroradiology, Univ Hosp Freiburg, Germany (S.H.); Faculty of Medicine Univ of Geneva, Switzerland (S.H.); Dept of Radiology, Stanford Univ, Stanford, Calif (G.Z.); Univ College London, Inst of Neurology, London, England (D.L.T., X.G.); Dept of Diagnostic and Interventional Neuroradiology, Geneva Univ Hosps,Switzerland (K.O.L.); Dept of Radiology & Nuclear Medicine and PET Research, VU Univ Medical Ctr, Amsterdam, the Netherlands (F.B.); and Insts of Neurology and Healthcare Engineering, Univ College London, England (F.B.)
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Nagakura Y. The need for fundamental reforms in the pain research field to develop innovative drugs. Expert Opin Drug Discov 2016; 12:39-46. [PMID: 27838932 DOI: 10.1080/17460441.2017.1261108] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Chronic pain is a major healthcare issue owing to its high prevalence, significant physical and emotional burden on the patients, and huge financial burden on the society. The efficacy of currently available medications is unsatisfactory owing to their limited effect size and the low responder rate (less than 50%). Thus, there is a large unmet need for innovative therapies for chronic pain. Areas covered: In this review, the author points out the need for fundamental reforms in pain research. For the last several decades, drug discovery research has extensively focused on designing new therapies using animal models of chronic pain. It has, however, made insufficient progress with respect to the launch of innovative analgesic drugs, because the translation from preclinical to clinical stages has not been satisfactory. Thus, the strategies for developing innovative analgesic drugs are discussed. Expert opinion: Points to be considered in the discovery of drugs for pain relief include: (1) the exclusion of bias incorporation and the alignment of clinical and preclinical endpoints in the assessment of analgesic efficacy; (2) the understanding of primary unmet needs; (3) the assessment of new therapies by biomarker-prioritized frameworks, and (4) the stratification of chronic pain sufferers.
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Affiliation(s)
- Yukinori Nagakura
- a Faculty of Pharmaceutical Sciences , Aomori University , Aomori-shi , Aomori , Japan
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Jiang J, Gu L, Bao D, Hong S, He W, Tan Y, Zeng X, Gong H, Zhang D, Zhou F. Altered homotopic connectivity in postherpetic neuralgia: a resting state fMRI study. J Pain Res 2016; 9:877-886. [PMID: 27826209 PMCID: PMC5096754 DOI: 10.2147/jpr.s117787] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective The aim of this study was to explore interhemispheric intrinsic connectivity in patients with postherpetic neuralgia (PHN). Methods We obtained resting-state functional magnetic resonance imaging data from 18 right-handed PHN patients (11 males, 7 females; mean age, 59.67±8.41 years) and 18 well-matched healthy controls (11 males, 7 females; mean age, 38.50±7.51 years). Interhemispheric connectivity was examined using voxel-mirrored homotopic connectivity (VMHC), and seed-based functional connectivity analysis was performed. Results Compared with the healthy controls, the patients with PHN showed abnormally decreased homotopic connectivity in the dorsolateral prefrontal cortex and the precuneus and posterior cingulate cortex (PCUN/PCC). The decreased VMHC in the PCUN/PCC was positively correlated with the visual analog scale of PHN in the PHN patient group (ρ=0.651; P=0.006). Receiver operating characteristic (ROC) analysis revealed that the areas under the curves for the two brain regions were 0.898 for the prefrontal cortex and 0.923 for the PCUN/PCC, which indicated that the VMHC could be used to discriminate PHN patients from healthy controls. A subsequent seed-based functional connectivity analysis revealed widely disrupted intrinsic connectivity between the regions that showed local homotopic connectivity deficits and the areas subserving the default-mode network. Conclusion Our results indicated reduced interhemispheric functional connectivity in patients with PHN, which seems to be an important new avenue to investigate to better understand the nature of disconnection of the functional architecture in patients with PHN.
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Affiliation(s)
| | - Lili Gu
- Department of Pain, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Dan Bao
- Department of Pain, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | | | | | | | | | | | - Daying Zhang
- Department of Pain, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China
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Dou Z, Zhang X, Yang L, Wang W, Li N, Liu Z, Ni J. Alternation of regional homogeneity in trigeminal neuralgia after percutaneous radiofrequency thermocoagulation: A resting state fMRI study. Medicine (Baltimore) 2016; 95:e5193. [PMID: 27759655 PMCID: PMC5079339 DOI: 10.1097/md.0000000000005193] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We used resting-state fMRI to investigate regional homogeneity (ReHo) changes in patients with TN before and after PRT procedure, and to speculate about its possible mechanisms.Thirty-one TN patients underwent the PRT procedure had MRI scans just before and 6 months after surgery. The anatomical and resting-state functional images were all acquired. Patients' visual analog scales (VAS) scores, facial numbness, and disease duration were also recorded. Voxel-wise ReHo analysis was performed to detect the altered regional clusters after surgery. The correlations between the mean ReHo values of each significant cluster and clinical variables were examined.Compared with presurgical condition, patients after the PRT procedure showed a significant ReHo value increases in the right fusiform gyrus (FG) and bilateral anterior cingulate cortex (ACC), but decreases in the left inferior parietal lobule (IPL), right calcarine, right middle temporal gyrus (MTG), left postcentral gyrus (PoCG), and left insula. We demonstrated a positive correlation between ReHo in the left PoCG and VAS scores, a negative correlation between pre-surgical ReHo in the right MTG and VAS changes (ΔVAS).Alterations of ReHo post-surgical were found in several regions, which are related to sensory, affective, and emotional processes. The MTG may be a specific area that is associated with analgesic efficiency of PRT procedure.
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Affiliation(s)
- Zhi Dou
- Department of Pain Management, Xuanwu Hospital Capital Medical University
| | - Xueyi Zhang
- School of Biomedical Engineering, Capital Medical University
| | - Liqiang Yang
- Department of Pain Management, Xuanwu Hospital Capital Medical University
| | - Wanqian Wang
- Department of Radiology, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Na Li
- Department of Pain Management, Xuanwu Hospital Capital Medical University
| | - Zhicheng Liu
- School of Biomedical Engineering, Capital Medical University
| | - Jiaxiang Ni
- Department of Pain Management, Xuanwu Hospital Capital Medical University
- Correspondence: Jiaxiang Ni, Xicheng District, Beijing, China (e-mail: )
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