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Huang S, Vigotsky AD, Apkarian AV, Huang L. Body mass index associated with respiration predicts motion in resting-state functional magnetic resonance imaging scans. Hum Brain Mapp 2024; 45:e70015. [PMID: 39225333 PMCID: PMC11369907 DOI: 10.1002/hbm.70015] [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: 03/06/2024] [Revised: 07/01/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024] Open
Abstract
Decreasing body mass index (BMI) reduces head motion in resting-state fMRI (rs-fMRI) data. Yet, the mechanism by which BMI affects head motion remains poorly understood. Understanding how BMI interacts with respiration to affect head motion can improve head motion reduction strategies. A total of 254 patients with back pain were included in this study, each of whom had two visits (interval time = 13.85 ± 7.81 weeks) during which two consecutive re-fMRI scans were obtained. We investigated the relationships between head motion and demographic and pain-related characteristics-head motion was reliable across scans and correlated with age, pain intensity, and BMI. Multiple linear regression models determined that BMI was the main determinant in predicting head motion. BMI was also associated with two features derived from respiration signal. Anterior-posterior and superior-inferior motion dominated both overall motion magnitude and the coupling between motion and respiration. BMI interacted with respiration to influence motion only in the pitch dimension. These findings indicate that BMI should be a critical parameter in both study designs and analyses of fMRI data.
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Affiliation(s)
- Shishi Huang
- Department of NeurologyThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Andrew D. Vigotsky
- Department of Biomedical EngineeringNorthwestern UniversityEvanstonIllinoisUSA
- Department of StatisticsNorthwestern UniversityEvanstonIllinoisUSA
| | - Apkar Vania Apkarian
- Department of Neuroscience, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Center for Translational Pain Research, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
| | - Lejian Huang
- Department of Neuroscience, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
- Center for Translational Pain Research, Feinberg School of MedicineNorthwestern UniversityChicagoIllinoisUSA
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Mei J, Hu Y. Degree centrality-based resting-state functional magnetic resonance imaging explores central mechanisms in lumbar disc herniation patients with chronic low back pain. Front Neurol 2024; 15:1370398. [PMID: 38919971 PMCID: PMC11197982 DOI: 10.3389/fneur.2024.1370398] [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: 01/15/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
Objective To investigate the central mechanism of lumbar disc herniation in patients with chronic low back pain (LDHCP) using resting-state functional magnetic resonance imaging (rs-fMRI) utilizing the Degree Centrality (DC) method. Methods Twenty-five LDHCP and twenty-two healthy controls (HCs) were enrolled, and rs-fMRI data from their brains were collected. We compared whole-brain DC values between the LDHCP and HC groups, and examined correlations between DC values within the LDHCP group and the Visual Analogue Score (VAS), Oswestry Dysfunction Index (ODI), and disease duration. Diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curve analysis. Results LDHCP patients exhibited increased DC values in the bilateral cerebellum and brainstem, whereas decreased DC values were noted in the left middle temporal gyrus and right post-central gyrus when compared with HCs. The DC values of the left middle temporal gyrus were positively correlated with VAS (r = 0.416, p = 0.039) and ODI (r = 0.405, p = 0.045), whereas there was no correlation with disease duration (p > 0.05). Other brain regions showed no significant correlations with VAS, ODI, or disease duration (p > 0.05). Furthermore, the results obtained from ROC curve analysis demonstrated that the Area Under the Curve (AUC) for the left middle temporal gyrus was 0.929. Conclusion The findings indicated local abnormalities in spontaneous neural activity and functional connectivity in the bilateral cerebellum, bilateral brainstem, left middle temporal gyrus, and right postcentral gyrus among LDHCP patients.
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Affiliation(s)
| | - Yong Hu
- Department of Radiology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
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Mei YD, Gao H, Chen WF, Zhu W, Gu C, Zhang JP, Tao JM, Hua XY. Research on the multidimensional brain remodeling mechanisms at the level of brain regions, circuits, and networks in patients with chronic lower back pain caused by lumbar disk herniation. Front Neurosci 2024; 18:1357269. [PMID: 38516315 PMCID: PMC10956359 DOI: 10.3389/fnins.2024.1357269] [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: 12/17/2023] [Accepted: 02/21/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction Chronic lower back pain (cLBP), frequently attributed to lumbar disk herniation (LDH), imposes substantial limitations on daily activities. Despite its prevalence, the neural mechanisms underlying lower back pain remain incompletely elucidated. Functional magnetic resonance imaging (fMRI) emerges as a non-invasive modality extensively employed for investigating neuroplastic changes in neuroscience. In this study, task-based and resting-state fMRI methodologies are employed to probe the central mechanisms of lower back pain. Methods The study included 71 chronic lower back pain patients (cLBP group) due to LDH and 80 age, gender, and education-matched healthy volunteers (HC group). The subjects are mainly middle-aged and elderly individuals. Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Japanese Orthopedic Association Scores (JOA) were recorded. Resting-state and task-based fMRI data were collected. Results/discussion No significant differences were observed in age, gender, and education level between the two groups. In the cLBP group during task execution, there was diffuse and reduced activation observed in the primary motor cortex and supplementary motor area. Additionally, during resting states, notable changes were detected in brain regions, particularly in the frontal lobe, primary sensory area, primary motor cortex, precuneus, and caudate nucleus, accompanied by alterations in Amplitude of Low Frequency Fluctuation, Regional Homogeneity, Degree Centrality, and functional connectivity. These findings suggest that chronic lower back pain may entail reduced excitability in sensory-motor areas during tasks and heightened activity in the sensory-motor network during resting states, along with modified functional connectivity in various brain regions.
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Affiliation(s)
- Yuan-Dong Mei
- Department of Hand Surgery, the Second People’s Hospital of Changshu, Changshu, China
| | - Hang Gao
- Department of Rehabilitation, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei-Fei Chen
- Department of Hand Surgery, the Second People’s Hospital of Changshu, Changshu, China
| | - Wei Zhu
- Department of Hand Surgery, the Second People’s Hospital of Changshu, Changshu, China
| | - Chen Gu
- Department of Hand Surgery, the Second People’s Hospital of Changshu, Changshu, China
| | - Jun-Peng Zhang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ji-Ming Tao
- Department of Rehabilitation, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xu-Yun Hua
- Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Huang Q, Jiang X, Jin Y, Wu B, Vigotsky AD, Fan L, Gu P, Tu W, Huang L, Jiang S. Immersive virtual reality-based rehabilitation for subacute stroke: a randomized controlled trial. J Neurol 2024; 271:1256-1266. [PMID: 37947856 PMCID: PMC10896795 DOI: 10.1007/s00415-023-12060-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE Few effective treatments improve upper extremity (UE) function after stroke. Immersive virtual reality (imVR) is a novel and promising strategy for stroke UE recovery. We assessed the extent to which imVR-based UE rehabilitation can augment conventional treatment and explored changes in brain functional connectivity (FC) that were related to the rehabilitation. METHODS An assessor-blinded, parallel-group randomized controlled trial was performed with 40 subjects randomly assigned to either imVR or Control group (1:1 allocation), each receiving rehabilitation 5 times per week for 3 weeks. Subjects in the imVR received both imVR and conventional rehabilitation, while those in the Control received conventional rehabilitation only. Our primary and secondary outcomes were the Fugl-Meyer assessment's upper extremity subscale (FMA-UE) and the Barthel Index (BI), respectively. Both intention-to-treat (ITT) and per-protocol (PP) analyses were performed to assess the effectiveness of the trial. For both the FMA-UE/BI, a one-way analysis of covariance (ANCOVA) model was used, with the FMA-UE/BI at post-intervention or at follow-up, respectively, as the dependent variable, the two groups as the independent variable, baseline FMA-UE/BI, age, sex, site, time since onset, hypertension and diabetes as covariates. RESULTS Both ITT and PP analyses demonstrated the effectiveness of imVR-based rehabilitation. The FMA-UE score was greater in the imVR compared with the Control at the post-intervention (mean difference: 9.1 (95% CI 1.6, 16.6); P = 0.019) and follow-up (mean difference:11.5 (95% CI 1.9, 21.0); P = 0.020). The results were consistent for BI scores. Moreover, brain FC analysis found that the motor function improvements were associated with a change in degree in ipsilesional premotor cortex and ipsilesional dorsolateral prefrontal cortex immediately following the intervention and in ipsilesional visual region and ipsilesional middle frontal gyrus after the 12-week follow-up. CONCLUSIONS ImVR-based rehabilitation is an effective tool that can improve the recovery of UE functional capabilities of subacute stroke patients when added to standard care. These improvements were associated with distinctive brain changes at two post-stroke timepoints. The study results will benefit future patients with stroke and provide evidence for a promising new method of stroke rehabilitation. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03086889.
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Affiliation(s)
- Qianqian Huang
- Department of Rehabilitation Medicine, Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
- Integrative and Optimized Medicine Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Xixi Jiang
- Department of Rehabilitation Medicine, Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
- Integrative and Optimized Medicine Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Yun Jin
- Department of Rehabilitation Medicine, Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
- Integrative and Optimized Medicine Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Bo Wu
- Department of Information, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Andrew D Vigotsky
- Departments of Biomedical Engineering and Statistics, Northwestern University, Evanston, IL, 60208, USA
| | - Linyu Fan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Pengpeng Gu
- Department of Rehabilitation Medicine, Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
- Integrative and Optimized Medicine Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Wenzhan Tu
- Department of Rehabilitation Medicine, Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
- Integrative and Optimized Medicine Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China
| | - Lejian Huang
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.
| | - Songhe Jiang
- Department of Rehabilitation Medicine, Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China.
- Integrative and Optimized Medicine Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, 325027, Zhejiang, China.
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Zhao H, Ran S, Gan K, Du Y, Li W. Pain sensitivity and quality of life of patients with burning mouth syndrome: a preliminary study in a Chinese population. BMC Oral Health 2023; 23:951. [PMID: 38041054 PMCID: PMC10693025 DOI: 10.1186/s12903-023-03689-2] [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: 10/11/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Burning mouth syndrome (BMS) is an oral-facial pain disorder involving the central and peripheral nervous systems, but the evidence for altered pain sensitivity remains inconclusive. The aim of this study was to investigate pain sensitivity and oral health-related quality of life (OHRQoL) in patients with BMS and to assess the relationship between them. METHODS Fifty Chinese patients with BMS (57.82 ± 11.2 years) and fifty age- and gender-matched healthy subjects (55.64 ± 10.1 years) participated in the study. The Pain Sensitivity Questionnaire (PSQ) was used to assess participants' pain sensitivity. The Oral Health Impact Profile (OHIP-14) was used to evaluate participants' OHRQoL. RESULTS The PSQ total score (p = 0.009), the PSQ minor score (p = 0.003) and the OHIP-14 score (p<0.05) of patients with BMS were significantly higher than those of the healthy subjects. Simple linear regression showed that the PSQ minor score was significantly associated with the OHIP-14 score in patients with BMS (β = 0.338, p = 0.016). CONCLUSION Patients with BMS have higher pain sensitivity than healthy subjects. Reducing pain sensitivity might help to improve the quality of life of patients with BMS.
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Affiliation(s)
- Hongsen Zhao
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China.
| | - Shujun Ran
- National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Kang Gan
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China
| | - Yajing Du
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China
| | - Wenlu Li
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China
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Zhou XC, Huang YB, Wu S, Hong SW, Tian Y, Hu HJ, Lv LJ, Lv ZZ. Lever positioning manipulation alters real-time brain activity in patients with lumbar disc herniation: An amplitude of low-frequency fluctuation and regional homogeneity study. Psychiatry Res Neuroimaging 2023; 334:111674. [PMID: 37413860 DOI: 10.1016/j.pscychresns.2023.111674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/24/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION Lumbar disk herniation (LDH) is the preeminent disease of lever positioning manipulation (LPM), a complex disorder involving alterations in brain function. Resting-state functional magnetic resonance imaging (rs-fMRI) has the advantages of non-trauma, zero radiation, and high spatial resolution, which has become an effective means to study brain science in contemporary physical therapy. Furthermore, it can better elucidate the response characteristics of the brain region of LPM intervention in LDH. We utilized two data analysis methods, the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) of rs-fMRI, to assess the effects of LPM on real-time brain activity in patients with LDH. METHODS Patients with LDH (Group 1, n = 21) and age-, gender- and education-matched healthy controls without LDH (Group 2, n = 21) were prospectively enrolled. Brain fMRI was performed for Group 1 at two-time points (TPs): before LPM (TP1) and after one LPM session (TP2). The healthy controls (Group 2) did not receive LPM and underwent only one fMRI scan. Participants in Group 1 completed clinical questionnaires assessing pain and functional disorders using a Visual Analog Scale and the Japanese Orthopaedic Association (JOA), respectively. Furthermore, we employed MNL90 (Montreal Neurological Institute) as a brain-specific template. RESULTS Compared to the healthy controls (Group 2), the patients with LDH (Group 1) had significant variation in ALFF and ReHo values in brain activity. After the LPM session (TP2), Group 1 at TP1 also showed significant variation in ALFF and ReHo values in brain activity. In addition, the latter (TP2 vs TP1) showed more significant changes in brain regions than the former (Group 1 vs Group 2). The ALFF values were increased in the Frontal_Mid_R and decreased in the Precentral_L in Group 1 at TP2 compared with TP1. The Reho values were increased in the Frontal_Mid_R and decreased in the Precentral_L in Group 1 at TP2 compared with TP1. The ALFF values were increased in the Precuneus_R and decreased in the Frontal_Mid_Orb_L in Group 1 compared with Group 2. Only three brain areas with significant activity in Group 1 compared with Group 2: Frontal_Mid_Orb_L, Frontal_Sup_Orb_L, and Frontal_Mid_R. ALFF value in the Frontal_Mid_R at TP2 correlated positively with the change rates of JOA scores between TP1 and TP2 (P = 0.04, r = 0.319, R2 = 0.102). DISCUSSION Patients with LDH showed abnormal brain ALFF and ReHo values, which were altered after LPM. The default mode network, prefrontal cortex, and primary somatosensory cortex regions could predict real-time brain activity for sensory and emotional pain management in patients with LDH after LPM.
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Affiliation(s)
- Xing-Chen Zhou
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China; Research Institute of Spinal manipulation, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China; Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yu-Bo Huang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China; Research Institute of Spinal manipulation, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Shuang Wu
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China; Research Institute of Spinal manipulation, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China; Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Shuang-Wei Hong
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China; Research Institute of Spinal manipulation, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China; Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yu Tian
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China; Research Institute of Spinal manipulation, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Hui-Jie Hu
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China; Research Institute of Spinal manipulation, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Li-Jiang Lv
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China; Research Institute of Spinal manipulation, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China.
| | - Zhi-Zhen Lv
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China; Research Institute of Spinal manipulation, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China; Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou, Zhejiang, China.
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Clinical Characteristics of Minimal Lumbar Disc Herniation and Efficacy of Percutaneous Endoscopic Lumbar Discectomy via Transforaminal Approach: A Retrospective Study. J Pers Med 2023; 13:jpm13030552. [PMID: 36983733 PMCID: PMC10054638 DOI: 10.3390/jpm13030552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/07/2023] [Accepted: 03/16/2023] [Indexed: 03/22/2023] Open
Abstract
Objective: To define the characteristics of Mini LDH, develop new diagnostic references and examine the clinical efficacy of percutaneous endoscopic lumbar discectomy via a transforaminal approach (TF-PELD) for it. Methods: A total of 72 patients who underwent TF-PELD with Mini LDH from September 2019 to October 2022 were enrolled in this retrospective study. The patients’ basic information, symptoms, number of outpatient visits, duration of conservative treatment, physical examination findings and so on were obtained from the medical records. Clinical effects of TF-PELD for Mini LDH were assessed by means of the following: the Visual Analog Scale (VAS) for low back pain (LBP) and leg pain, Oswestry Disability Index (ODI) for functional status assessment and Modified Mac Nab criteria for patient satisfaction. Results: Mini LDH have specific clinical characteristics and imaging features. All included patients achieved obvious pain relief after TF-PELD surgery. Pain scores were repeated at postoperative day 1 and 1, 3, 6, 12 and 24 months later. Results were statistically analyzed. The average VAS-Back, VAS-Leg and ODI scores were all significantly reduced at the first postoperative day and gradually decreased with the follow-up time continuing. In total, 66 out of 72 patients received an excellent or good recovery and no poor result was reported according to the Modified Mac Nab criteria. Conclusions: Mini LDH is a type of LDH with special characteristics and in need of correct diagnosis and active treatment in clinical work. TF-PELD was also found to be an effective procedure for the treatment of Mini LDH.
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Chen XM, Wen Y, Chen S, Jin X, Liu C, Wang W, Kong N, Ling DY, Huang Q, Chai JE, Zhao XL, Li J, Xu MS, Jiang Z, Du HG. Traditional Chinese Manual Therapy (Tuina) reshape the function of default mode network in patients with lumbar disc herniation. Front Neurosci 2023; 17:1125677. [PMID: 37008205 PMCID: PMC10050335 DOI: 10.3389/fnins.2023.1125677] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/24/2023] [Indexed: 03/17/2023] Open
Abstract
PurposeInvestigating the changes of regional homogeneity (ReHo) values and both static and dynamic functional connectivity (FC) before and after Traditional Chinese Manual Therapy (Tuina) in patients with lumbar disk herniation (LDH) through resting-state functional magnetic resonance imaging (RS-fMRI). Based on this, we observe the effect of Tuina on the above abnormal changes.MethodsPatients with LDH (n = 27) and healthy controls (HCs) (n = 28) were recruited. The functional magnetic resonance imaging (fMRI) scanning was performed two times in LDH patients, before Tuina (time point 1, LDH-pre) and after the sixth Tuina (time point 2, LDH-pos). And for one time in HCs which received no intervention. The ReHo values were compared between LDH-pre and HCs. The significant clusters detected by ReHo analysis were selected as seeds to calculate static functional connectivity (sFC). We also applied the sliding-window to perform dynamic functional connectivity (dFC). To evaluate the Tuina effect, the mean ReHo and FC values (both static and dynamic) were extracted from significant clusters and compared between LDH and HCs.ResultsIn comparison to HCs, LDH patients displayed decreased ReHo in the left orbital part middle frontal gyrus (LO-MFG). For sFC analysis, no significant difference was found. However, we found decreased dFC variance between LO-MFG and the left Fusiform, and increased dFC variance in the left orbital inferior frontal gyrus and left precuneus. Both ReHo and dFC values revealed after Tuina, the brain activities in LDH patients were similar to HCs.ConclusionThe present study characterized the altered patterns of regional homogeneity in spontaneous brain activity and those of functional connectivity in patients with LDH. Tuina can reshape the function of the default mode network (DMN) in LDH patients, which may contribute to the analgesic effect of Tuina in LDH patients.
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Affiliation(s)
- Xiao-Min Chen
- Department of Tuina, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Ya Wen
- Department of Tuina, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Shao Chen
- Department of Tuina, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Xin Jin
- Department of Tuina, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Chen Liu
- Department of Tuina, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Wei Wang
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Ning Kong
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Dong-Ya Ling
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Qin Huang
- Department of Tuina, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Jin-Er Chai
- Department of Tuina, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Xiao-Lei Zhao
- Department of Tuina, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Jie Li
- Department of Radiology, Changshu No.2 People’s Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu, China
| | - Mao-Sheng Xu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Zhong Jiang
- Department of Tuina, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- Zhong Jiang,
| | - Hong-Gen Du
- Department of Tuina, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- *Correspondence: Hong-Gen Du,
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Bosak N, Branco P, Kuperman P, Buxbaum C, Cohen RM, Fadel S, Zubeidat R, Hadad R, Lawen A, Saadon‐Grosman N, Sterling M, Granovsky Y, Apkarian AV, Yarnitsky D, Kahn I. Brain Connectivity Predicts Chronic Pain in Acute Mild Traumatic Brain Injury. Ann Neurol 2022; 92:819-833. [PMID: 36082761 PMCID: PMC9826527 DOI: 10.1002/ana.26463] [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: 01/24/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Previous studies have established the role of the cortico-mesolimbic and descending pain modulation systems in chronic pain prediction. Mild traumatic brain injury (mTBI) is an acute pain model where chronic pain is prevalent and complicated for prediction. In this study, we set out to study whether functional connectivity (FC) of the nucleus accumbens (NAc) and the periaqueductal gray matter (PAG) is predictive of pain chronification in early-acute mTBI. METHODS To estimate FC, resting-state functional magnetic resonance imaging (fMRI) of 105 participants with mTBI following a motor vehicle collision was acquired within 72 hours post-accident. Participants were classified according to pain ratings provided at 12-months post-collision into chronic pain (head/neck pain ≥30/100, n = 44) and recovery (n = 61) groups, and their FC maps were compared. RESULTS The chronic pain group exhibited reduced negative FC between NAc and a region within the primary motor cortex corresponding with the expected representation of the area of injury. A complementary pattern was also demonstrated between PAG and the primary somatosensory cortex. PAG and NAc also shared increased FC to the rostral anterior cingulate cortex (rACC) within the recovery group. Brain connectivity further shows high classification accuracy (area under the curve [AUC] = .86) for future chronic pain, when combined with an acute pain intensity report. INTERPRETATION FC features obtained shortly after mTBI predict its transition to long-term chronic pain, and may reflect an underlying interaction of injury-related primary sensorimotor cortical areas with the mesolimbic and pain modulation systems. Our findings indicate a potential predictive biomarker and highlight targets for future early preventive interventions. ANN NEUROL 2022;92:819-833.
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Affiliation(s)
- Noam Bosak
- Rappaport Faculty of MedicineTechnion – Israel Institute of TechnologyHaifaIsrael,Department of NeurologyRambam Health Care CampusHaifaIsrael
| | - Paulo Branco
- Department of NeuroscienceNorthwestern University Medical SchoolChicagoIL
| | - Pora Kuperman
- Rappaport Faculty of MedicineTechnion – Israel Institute of TechnologyHaifaIsrael
| | - Chen Buxbaum
- Rappaport Faculty of MedicineTechnion – Israel Institute of TechnologyHaifaIsrael,Department of NeurologyRambam Health Care CampusHaifaIsrael
| | - Ruth Manor Cohen
- Rappaport Faculty of MedicineTechnion – Israel Institute of TechnologyHaifaIsrael
| | - Shiri Fadel
- Department of NeurologyRambam Health Care CampusHaifaIsrael
| | - Rabab Zubeidat
- Rappaport Faculty of MedicineTechnion – Israel Institute of TechnologyHaifaIsrael
| | - Rafi Hadad
- Department of NeurologyRambam Health Care CampusHaifaIsrael
| | - Amir Lawen
- Rappaport Faculty of MedicineTechnion – Israel Institute of TechnologyHaifaIsrael
| | - Noam Saadon‐Grosman
- Department of Medical Neurobiology, Faculty of MedicineThe Hebrew UniversityJerusalemIsrael
| | - Michele Sterling
- RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Road Traffic Injury RecoveryThe University of QueenslandBrisbaneAustralia
| | - Yelena Granovsky
- Rappaport Faculty of MedicineTechnion – Israel Institute of TechnologyHaifaIsrael
| | | | - David Yarnitsky
- Rappaport Faculty of MedicineTechnion – Israel Institute of TechnologyHaifaIsrael,Department of NeurologyRambam Health Care CampusHaifaIsrael
| | - Itamar Kahn
- Rappaport Faculty of MedicineTechnion – Israel Institute of TechnologyHaifaIsrael
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10
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Yang L, Vigotsky AD, Wu B, Shen B, Yan Z, Apkarian AV, Huang L. Morphometric similarity networks discriminate patients with lumbar disc herniation from healthy controls and predict pain intensity. FRONTIERS IN NETWORK PHYSIOLOGY 2022; 2:992662. [PMID: 36926079 PMCID: PMC10013053 DOI: 10.3389/fnetp.2022.992662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022]
Abstract
We used a recently advanced technique, morphometric similarity (MS), in a large sample of lumbar disc herniation patients with chronic pain (LDH-CP) to examine morphometric features derived from multimodal MRI data. To do so, we evenly allocated 136 LDH-CPs to exploratory and validation groups with matched healthy controls (HC), randomly chosen from the pool of 157 HCs. We developed three MS-based models to discriminate LDH-CPs from HCs and to predict the pain intensity of LDH-CPs. In addition, we created analogous models using resting state functional connectivity (FC) to perform the above discrimination and prediction of pain, in addition to comparing the performance of FC- and MS-based models and investigating if an ensemble model, combining morphometric features and resting-state signals, could improve performance. We conclude that 1) MS-based models were able to discriminate LDH-CPs from HCs and the MS networks (MSN) model performed best; 2) MSN was able to predict the pain intensity of LDH-CPs; 3) FC networks constructed were able to discriminate LDH-CPs from HCs, but they could not predict pain intensity; and 4) the ensemble model neither improved discrimination nor pain prediction performance. Generally, MSN is sensitive enough to uncover brain morphology alterations associated with chronic pain and provides novel insights regarding the neuropathology of chronic pain.
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Affiliation(s)
- Lili Yang
- Department of Radiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Andrew D. Vigotsky
- Departments of Biomedical Engineering and Statistics, Northwestern University, Evanston, IL, United States
| | - Binbin Wu
- Department of Pain Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bangli Shen
- Department of Pain Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhihan Yan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - A. Vania Apkarian
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Center for Translational Pain Research, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Lejian Huang
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Center for Translational Pain Research, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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11
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Smith JL, Allen JW, Fleischer CC, Harper DE. Topology of pain networks in patients with temporomandibular disorder and pain-free controls with and without concurrent experimental pain: A pilot study. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2022; 3:966398. [PMID: 36324873 PMCID: PMC9619074 DOI: 10.3389/fpain.2022.966398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/26/2022] [Indexed: 11/26/2022]
Abstract
Temporomandibular disorders (TMD) involve chronic pain in the masticatory muscles and jaw joints, but the mechanisms underlying the pain are heterogenous and vary across individuals. In some cases, structural, functional, and metabolic changes in the brain may underlie the condition. In the present study, we evaluated the functional connectivity between 86 regions of interest (ROIs), which were chosen based on previously reported neuroimaging studies of pain and differences in brain morphology identified in an initial surface-based morphometry analysis. Our main objectives were to investigate the topology of the network formed by these ROIs and how it differs between individuals with TMD and chronic pain (n = 16) and pain-free control participants (n = 12). In addition to a true resting state functional connectivity scan, we also measured functional connectivity during a 6-min application of a noxious cuff stimulus applied to the left leg. Our principal finding is individuals with TMD exhibit more suprathreshold correlations (higher nodal degree) among all ROIs but fewer "hub" nodes (i.e., decreased betweenness centrality) across conditions and across all pain pathways. These results suggest is this pain-related network of nodes may be "over-wired" in individuals with TMD and chronic pain compared to controls, both at rest and during experimental pain.
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Affiliation(s)
- Jeremy L. Smith
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Jason W. Allen
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States,Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
| | - Candace C. Fleischer
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States,Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Daniel E. Harper
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, United States,Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States,Correspondence: Daniel E. Harper
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12
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Jiao X, Yuan M, Li Q, Huang Y, Ji M, Li J, Yan S, Sun H, Wang X, Pan Z, Ren Q, Wang D, Wang G. Brain Morphological and Functional Changes in Adenomyosis with Pain: A Resting State Functional Magnetic Resonance Imaging Study. J Clin Med 2022; 11:jcm11185286. [PMID: 36142933 PMCID: PMC9504732 DOI: 10.3390/jcm11185286] [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: 08/08/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022] Open
Abstract
The absence of clinically objective methods to evaluate adenomyosis-associated pain and the poor understanding of its pathophysiology lead to treatment limitations. We conducted a resting-state functional magnetic resonance imaging study with 49 patients with pain-related adenomyosis and 30 pain-free controls to investigate brain morphological alterations and regional dysfunctions in patients with pain-related adenomyosis. These patients had significantly higher scores for anxiety and depression than the control group (p < 0.05). They also had a lower gray matter volume (GMV) in the bilateral insula, left angular gyrus, precuneus, left inferior temporal gyrus, and left postcentral gyrus (p < 0.05, AlphaSim corrected). Similarly, decreased voxel-mirrored homotopic connectivity was observed in the bilateral insula, posterior cingulate cortex, middle frontal gyrus, and postcentral gyrus in the adenomyosis patient group (p < 0.05, AlphaSim corrected). Regional homogeneity showed significant differences mainly in the bilateral cerebellum, left inferior frontal gyrus, medial prefrontal cortex, and posterior cingulate gyrus. Correlation analysis showed that the degree of depression in patients with adenomyosis was negatively correlated with the GMV of the left angular gyrus. The results show that these patients exhibited changes in multiple brain regions associated with pain as well as emotion perception and processing.
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Affiliation(s)
- Xue Jiao
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan 250012, China
- Department of Gynecology, Shandong Provincial Hospital, Jinan 250021, China
- Medical Integration and Practice Center, Shandong University, Jinan 250012, China
| | - Ming Yuan
- Department of Gynecology, Shandong Provincial Hospital, Jinan 250021, China
| | - Qiuju Li
- Department of Gynecology, Shandong Provincial Hospital, Jinan 250021, China
| | - Yufei Huang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan 250012, China
- Department of Gynecology, Shandong Provincial Hospital, Jinan 250021, China
- Medical Integration and Practice Center, Shandong University, Jinan 250012, China
| | - Miaomiao Ji
- Maternal and Child Health Care Hospital of Shandong Province, Jinan 250014, China
| | - Jing Li
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan 250012, China
- Department of Gynecology, Shandong Provincial Hospital, Jinan 250021, China
- Medical Integration and Practice Center, Shandong University, Jinan 250012, China
| | - Shumin Yan
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan 250012, China
- Department of Gynecology, Shandong Provincial Hospital, Jinan 250021, China
- Medical Integration and Practice Center, Shandong University, Jinan 250012, China
| | - Hao Sun
- Department of Gynecology, Shandong Provincial Hospital, Jinan 250021, China
- Medical Integration and Practice Center, Shandong University, Jinan 250012, China
| | - Xinyu Wang
- Department of Gynecology, Shandong Provincial Hospital, Jinan 250021, China
- Medical Integration and Practice Center, Shandong University, Jinan 250012, China
| | - Zangyu Pan
- Department of Gynecology, Shandong Provincial Hospital, Jinan 250021, China
- Medical Integration and Practice Center, Shandong University, Jinan 250012, China
| | - Qianhui Ren
- Department of Gynecology, Shandong Provincial Hospital, Jinan 250021, China
- Medical Integration and Practice Center, Shandong University, Jinan 250012, China
| | - Dawei Wang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan 250012, China
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan 250012, China
- Institute of Brain and Brain-Inspired Science, Shandong University, Jinan 250012, China
- Correspondence: (D.W.); (G.W.); Tel.: +86-185-6008-1661 (D.W.); +86-185-6008-1729 (G.W.)
| | - Guoyun Wang
- Department of Gynecology, Shandong Provincial Hospital, Jinan 250021, China
- Medical Integration and Practice Center, Shandong University, Jinan 250012, China
- Correspondence: (D.W.); (G.W.); Tel.: +86-185-6008-1661 (D.W.); +86-185-6008-1729 (G.W.)
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13
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Heitmann H, Gil Ávila C, Nickel MM, Ta Dinh S, May ES, Tiemann L, Hohn VD, Tölle TR, Ploner M. Longitudinal resting-state electroencephalography in patients with chronic pain undergoing interdisciplinary multimodal pain therapy. Pain 2022; 163:e997-e1005. [PMID: 35050961 PMCID: PMC9393803 DOI: 10.1097/j.pain.0000000000002565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/10/2021] [Accepted: 12/03/2021] [Indexed: 11/27/2022]
Abstract
ABSTRACT Chronic pain is a major healthcare issue posing a large burden on individuals and society. Converging lines of evidence indicate that chronic pain is associated with substantial changes of brain structure and function. However, it remains unclear which neuronal measures relate to changes of clinical parameters over time and could thus monitor chronic pain and treatment responses. We therefore performed a longitudinal study in which we assessed clinical characteristics and resting-state electroencephalography data of 41 patients with chronic pain before and 6 months after interdisciplinary multimodal pain therapy. We specifically assessed electroencephalography measures that have previously been shown to differ between patients with chronic pain and healthy people. These included the dominant peak frequency; the amplitudes of neuronal oscillations at theta, alpha, beta, and gamma frequencies; as well as graph theory-based measures of brain network organization. The results show that pain intensity, pain-related disability, and depression were significantly improved after interdisciplinary multimodal pain therapy. Bayesian hypothesis testing indicated that these clinical changes were not related to changes of the dominant peak frequency or amplitudes of oscillations at any frequency band. Clinical changes were, however, associated with an increase in global network efficiency at theta frequencies. Thus, changes in chronic pain might be reflected by global network changes in the theta band. These longitudinal insights further the understanding of the brain mechanisms of chronic pain. Beyond, they might help to identify biomarkers for the monitoring of chronic pain.
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Affiliation(s)
- Henrik Heitmann
- Technical University of Munich (TUM), School of Medicine, Department of Neurology, Munich, Germany
- TUM, School of Medicine, TUM-Neuroimaging Center, Munich, Germany
- TUM, School of Medicine, Center for Interdisciplinary Pain Medicine, Munich, Germany
| | - Cristina Gil Ávila
- Technical University of Munich (TUM), School of Medicine, Department of Neurology, Munich, Germany
- TUM, School of Medicine, TUM-Neuroimaging Center, Munich, Germany
| | - Moritz M. Nickel
- Technical University of Munich (TUM), School of Medicine, Department of Neurology, Munich, Germany
- TUM, School of Medicine, TUM-Neuroimaging Center, Munich, Germany
| | - Son Ta Dinh
- Technical University of Munich (TUM), School of Medicine, Department of Neurology, Munich, Germany
- TUM, School of Medicine, TUM-Neuroimaging Center, Munich, Germany
| | - Elisabeth S. May
- Technical University of Munich (TUM), School of Medicine, Department of Neurology, Munich, Germany
- TUM, School of Medicine, TUM-Neuroimaging Center, Munich, Germany
| | - Laura Tiemann
- Technical University of Munich (TUM), School of Medicine, Department of Neurology, Munich, Germany
- TUM, School of Medicine, TUM-Neuroimaging Center, Munich, Germany
| | - Vanessa D. Hohn
- Technical University of Munich (TUM), School of Medicine, Department of Neurology, Munich, Germany
- TUM, School of Medicine, TUM-Neuroimaging Center, Munich, Germany
| | - Thomas R. Tölle
- Technical University of Munich (TUM), School of Medicine, Department of Neurology, Munich, Germany
- TUM, School of Medicine, Center for Interdisciplinary Pain Medicine, Munich, Germany
| | - Markus Ploner
- Technical University of Munich (TUM), School of Medicine, Department of Neurology, Munich, Germany
- TUM, School of Medicine, TUM-Neuroimaging Center, Munich, Germany
- TUM, School of Medicine, Center for Interdisciplinary Pain Medicine, Munich, Germany
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14
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Li Z, Zhao L, Ji J, Ma B, Zhao Z, Wu M, Zheng W, Zhang Z. Temporal Grading Index of Functional Network Topology Predicts Pain Perception of Patients With Chronic Back Pain. Front Neurol 2022; 13:899254. [PMID: 35756935 PMCID: PMC9226296 DOI: 10.3389/fneur.2022.899254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Chronic back pain (CBP) is a maladaptive health problem affecting the brain function and behavior of the patient. Accumulating evidence has shown that CBP may alter the organization of functional brain networks; however, whether the severity of CBP is associated with changes in dynamics of functional network topology remains unclear. Here, we generated dynamic functional networks based on resting-state functional magnetic resonance imaging (rs-fMRI) of 34 patients with CBP and 34 age-matched healthy controls (HC) in the OpenPain database via a sliding window approach, and extracted nodal degree, clustering coefficient (CC), and participation coefficient (PC) of all windows as features to characterize changes of network topology at temporal scale. A novel feature, named temporal grading index (TGI), was proposed to quantify the temporal deviation of each network property of a patient with CBP to the normal oscillation of the HCs. The TGI of the three features achieved outstanding performance in predicting pain intensity on three commonly used regression models (i.e., SVR, Lasso, and elastic net) through a 5-fold cross-validation strategy, with the minimum mean square error of 0.25 ± 0.05; and the TGI was not related to depression symptoms of the patients. Furthermore, compared to the HCs, brain regions that contributed most to prediction showed significantly higher CC and lower PC across time windows in the CBP cohort. These results highlighted spatiotemporal changes in functional network topology in patients with CBP, which might serve as a valuable biomarker for assessing the sensation of pain in the brain and may facilitate the development of CBP management/therapy approaches.
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Affiliation(s)
- Zhonghua Li
- Department of Rehabilitation Medicine, Gansu Provincial Hospital of TCM, Lanzhou, China
| | - Leilei Zhao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Jing Ji
- Department of Rehabilitation Medicine, Gansu Provincial Hospital of TCM, Lanzhou, China
| | - Ben Ma
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhiyong Zhao
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Miao Wu
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Weihao Zheng
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Zhe Zhang
- Institute of Brain Science, Hangzhou Normal University, Hangzhou, China.,School of Physics, Hangzhou Normal University, Hangzhou, China
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15
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Brain Network Changes in Lumbar Disc Herniation Induced Chronic Nerve Roots Compression Syndromes. Neural Plast 2022; 2022:7912410. [PMID: 35607420 PMCID: PMC9124092 DOI: 10.1155/2022/7912410] [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: 09/21/2021] [Revised: 01/04/2022] [Accepted: 04/08/2022] [Indexed: 11/18/2022] Open
Abstract
Lumbar disc herniation (LDH) induced nerve compression syndromes have been a prevalent problem with complex neural mechanisms. Changes in distributed brain areas are involved in the occurrence and persistence of syndromes. The present study aimed to investigate the changes of brain functional network in LDH patients with chronic sciatica using graph theory analysis. A total of thirty LDH adults presenting L4 and/or L5 root (s) compression syndromes (LDH group) and thirty age-, sex-, BMI- and education-matched healthy control (HC group) were recruited for functional MRI scan. Whole-brain functional network was constructed for each participant using Pearson's correlation. Global and nodal properties were calculated and compared between two groups, including small-worldness index, clustering coefficient, characteristic path length, degree centrality (DC), betweenness centrality (BC) and nodal efficiency. Both LDH and HC groups showed small-world architecture in the functional network of brain. However, LDH group showed that nodal centralities (DC, BC and nodal efficiency) increased in opercular part of inferior frontal gyrus; and decreased in orbital part of inferior frontal gyrus, lingual cortex and inferior occipital gyrus. The DC and efficiency in the right inferior occipital gyrus were negatively related with the Oswestry Disability Index in LDH group. In conclusion, the LDH-related chronic sciatica syndromes may induce regional brain alterations involving self-referential, emotional responses and pain regulation functions. But the whole-brain small-world architecture was not significantly disturbed. It may provide new insights into LDH patients with radicular symptoms from new perspectives.
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16
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Chao CC, Hsieh PC, Janice Lin CH, Huang SL, Hsieh ST, Chiang MC. Impaired brain network architecture as neuroimaging evidence of pain in diabetic neuropathy. Diabetes Res Clin Pract 2022; 186:109833. [PMID: 35314258 DOI: 10.1016/j.diabres.2022.109833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/14/2022] [Accepted: 03/16/2022] [Indexed: 11/17/2022]
Abstract
AIMS To investigate alterations in structural brain networks due to chronic diabetic neuropathic pain. METHODS The current study recruited 24 patients with painful diabetic neuropathy (PDN) to investigate the influences of chronic pain on the brain. Thirteen patients with painless diabetic neuropathy (PLDN) and 24 healthy adults were recruited as disease and healthy controls. White matter connectivity of the brain networks constructed by diffusion tractography was compared across groups using the Network-based statistic (NBS) method. Graph theoretical analysis was further applied to assess topological changes of the brain networks. RESULTS The PDN patients had a significant reduction in white matter connectivity compared with PLDN and controls in the limbic and temporal regions, particularly the insula, hippocampus and parahippocampus, the amygdala, and the middle temporal gyrus. The PDN patients also exhibited an altered topology of the brain networks with reduced global efficiency and betweenness centrality. CONCLUSION The current findings indicate that topological alterations of brain networks may serve as a biomarker for pain-induced maladaptive reorganization of the brain in PDN. Given the high prevalence of diabetes worldwide, novel insights from network sciences to investigate the central mechanisms of diabetic neuropathic pain are warranted.
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Affiliation(s)
- Chi-Chao Chao
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
| | - Paul-Chen Hsieh
- Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Ho Janice Lin
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan; Yeong-An Orthopedic and Physical Therapy Clinic, Taipei, Taiwan
| | - Shin-Leh Huang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Neurology, Fu Jen Catholic University Hospital, New Taipei City, 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; Center of Precision Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Ming-Chang Chiang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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17
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Huang Q, Lin D, Huang S, Cao Y, Jin Y, Wu B, Fan L, Tu W, Huang L, Jiang S. Brain Functional Topology Alteration in Right Lateral Occipital Cortex Is Associated With Upper Extremity Motor Recovery. Front Neurol 2022; 13:780966. [PMID: 35309550 PMCID: PMC8927543 DOI: 10.3389/fneur.2022.780966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/17/2022] [Indexed: 12/02/2022] Open
Abstract
Stroke is a chief cause of sudden brain damage that severely disrupts the whole-brain network. However, the potential mechanisms of motor recovery after stroke are uncertain and the prognosis of poststroke upper extremity recovery is still a challenge. This study investigated the global and local topological properties of the brain functional connectome in patients with subacute ischemic stroke and their associations with the clinical measurements. A total of 57 patients, consisting of 29 left-sided and 28 right-sided stroke patients, and 32 age- and gender-matched healthy controls (HCs) were recruited to undergo a resting-state functional magnetic resonance imaging (rs-fMRI) study; patients were also clinically evaluated with the Upper Extremity Fugl-Meyer Assessment (FMA_UE). The assessment was repeated at 15 weeks to assess upper extremity functional recovery for the patient remaining in the study (12 left- 20 right-sided stroke patients). Global graph topological disruption indices of stroke patients were significantly decreased compared with HCs but these indices were not significantly associated with FMA_UE. In addition, local brain network structure of stroke patients was altered, and the altered regions were dependent on the stroke site. Significant associations between local degree and motor performance and its recovery were observed in the right lateral occipital cortex (R LOC) in the right-sided stroke patients. Our findings suggested that brain functional topologies alterations in R LOC are promising as prognostic biomarkers for right-sided subacute stroke. This cortical area might be a potential target to be further validated for non-invasive brain stimulation treatment to improve poststroke upper extremity recovery.
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Affiliation(s)
- Qianqian Huang
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Intelligent Rehabilitation Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, China
| | - Dinghong Lin
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Intelligent Rehabilitation Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, China
| | - Shishi Huang
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yungang Cao
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yun Jin
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Intelligent Rehabilitation Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, China
| | - Bo Wu
- Department of Information, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Linyu Fan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wenzhan Tu
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Intelligent Rehabilitation Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, China
| | - Lejian Huang
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- *Correspondence: Lejian Huang
| | - Songhe Jiang
- Rehabilitation Medicine Center, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Intelligent Rehabilitation Research Center, China-USA Institute for Acupuncture and Rehabilitation, Wenzhou Medical University, Wenzhou, China
- Songhe Jiang
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18
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Barroso J, Branco P, Apkarian AV. Brain mechanisms of chronic pain: critical role of translational approach. Transl Res 2021; 238:76-89. [PMID: 34182187 PMCID: PMC8572168 DOI: 10.1016/j.trsl.2021.06.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/16/2021] [Accepted: 06/19/2021] [Indexed: 01/15/2023]
Abstract
Chronic pain is a leading cause of disability worldwide and its prevalence is likely to increase over the next decades. Treatment for chronic pain remains insufficient and therapeutical advances have not made comparable progress with that for many chronic disorders, thus amplifying the concern on the future burden of the disease. At the same time, and even after decades of intense research, the underlying pathophysiology of chronic pain remains minimally understood. We believe advancing our current understanding of chronic pain requires mechanistically explicit, hypothesis-driven, and clinically focused models. In this review we highlight some of the main findings over the last decades that have contributed to the present knowledge of brain mechanisms of chronic pain, and how such advances were possible due to a reverse translational research approach. We argue that this approach is essential in the chronic pain field, in order to generate new scientific hypotheses, probe physiological mechanisms, develop therapeutic strategies and translate findings back into promising human clinical trials.
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Affiliation(s)
- Joana Barroso
- Department of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Department of Physical Medicine and Rehabilitation, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Center for Chronic Pain and Drug Abuse, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Paulo Branco
- Department of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Center for Chronic Pain and Drug Abuse, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Apkar Vania Apkarian
- Department of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Department of Physical Medicine and Rehabilitation, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Center for Chronic Pain and Drug Abuse, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Department of Anesthesiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
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Xia Z, Zhou T, Mamoon S, Lu J. Recognition of Dementia Biomarkers With Deep Finer-DBN. IEEE Trans Neural Syst Rehabil Eng 2021; 29:1926-1935. [PMID: 34506288 DOI: 10.1109/tnsre.2021.3111989] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The treatment of neurodegenerative diseases is expensive, and long-term treatment makes families bear a heavy burden. Accumulating evidence suggests that the high conversion rate can possibly be reduced if clinical interventions are applied at the early stage of brain diseases. Thus, a variety of deep learning methods are utilized to recognize the early stages of neurodegenerative diseases for clinical intervention and treatment. However, most existing methods have ignored the issue of sample imbalance, which often makes it difficult to train an effective model due to lack of a large number of negative samples. To address this problem, we propose a two-stage method, which is used to learn the compression and recover rules of normal subjects so that potential negative samples can be detected. The experimental results show that the proposed method can not only obtain a superb recognition result, but also give an explanation that conforms to the physiological mechanism. Most importantly, the deep learning model does not need to be retrained for each type of disease, which can be widely applied to the diagnosis of various brain diseases. Furthermore, this research could have great potential in understanding regional dysfunction of various brain diseases.
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20
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Fast Independent Component Analysis Algorithm-Based Diagnosis of L5 Nerve Root Compression and Changes of Brain Functional Areas Using 3D Functional Magnetic Resonance Imaging. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:5063021. [PMID: 34336154 PMCID: PMC8321732 DOI: 10.1155/2021/5063021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/14/2021] [Indexed: 11/17/2022]
Abstract
In this paper, the application of 3-dimensional (3D) functional magnetic resonance imaging (FMRI) in the diagnosis of the 5th lumbar (L5) nerve root compression and brain functional areas in patients with lumbar disc herniation (LDH) was analyzed. The traditional fast independent component analysis (Fast ICA) algorithm was optimized based on the modified whitening matrix to establish a new type of Modified-Fast ICA (M-Fast ICA) algorithm that was compared with the introduced traditional Fast ICA and ICA. M-Fast ICA was applied to the 3D FMRI diffusion tensor imaging (DTI) evaluation of 65 patients with L5 nerve root pain due to LDH (group A) and 50 healthy volunteers (group B). The values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in the lumbar nerve roots (L3, L4, L5, and the 1st sacral vertebra (S1)) were recorded among subjects from the two groups. Besides, the score of edema degree in the lumbar nerve roots (L5 and S1) and activity of brain functional areas were also recorded among all subjects of the two groups. The results showed that the mean square error of M-Fast ICA was smaller than that of traditional Fast ICA and ICA, while its signal-to-noise ratio (SNR) was greater than that of Fast ICA and ICA (P < 0.05). The FA of L5 and S1 nerve roots in patients of group A was sharply lower than the values of group B, while the ADC of patients in group A was greater than that of the control group (P < 0.05). Besides, the score of edema in L5 and S1 nerve roots of patients in group A increased in contrast to group B (P < 0.05). The brain areas were activated after surgery including bilateral temporal lobe, left thalamus, splenium of corpus callosum, and right internal capsule. In conclusion, the 3D image denoising performance of M-Fast ICA optimized and constructed in this study was superior to that of the traditional Fast ICA and ICA. The FA of patients with L5 nerve root pain due to LDH decreased steeply, while the ADC increased dramatically. L5 nerve root pain caused by LDH resulted in changes in brain functional areas of the patients to inhibit the resting state default network activity, and the corresponding brain functional areas could be activated through treatment.
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21
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Pratscher S, Mickle AM, Marks JG, Rocha H, Bartsch F, Schmidt J, Tejera L, Garcia S, Custodero C, Jean F, Garvan C, Johnson AJ, Pop R, Greene A, Woods AJ, Staud R, Fillingim RB, Keil A, Sibille KT. Optimizing Chronic Pain Treatment with Enhanced Neuroplastic Responsiveness: A Pilot Randomized Controlled Trial. Nutrients 2021; 13:1556. [PMID: 34063083 PMCID: PMC8147927 DOI: 10.3390/nu13051556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/23/2021] [Accepted: 04/30/2021] [Indexed: 02/07/2023] Open
Abstract
Chronic pain affects mental and physical health and alters brain structure and function. Interventions that reduce chronic pain are also associated with changes in the brain. A number of non-invasive strategies can promote improved learning and memory and increase neuroplasticity in older adults. Intermittent fasting and glucose administration represent two such strategies with the potential to optimize the neurobiological environment to increase responsiveness to recognized pain treatments. The purpose of the pilot study was to test the feasibility and acceptability of intermittent fasting and glucose administration paired with a recognized pain treatment activity, relaxation and guided imagery. A total of 32 adults (44% W, 56% M), 50 to 85 years of age, with chronic knee pain for three months or greater participated in the study. Four sessions were completed over an approximate two-week period. Findings indicate the ability to recruit, randomize, and retain participants in the protocol. The procedures and measures were reasonable and completed without incident. Participant adherence was high and exit interview feedback positive. In summary, the pilot study was feasible and acceptable, providing the evidence necessary to move forward with a larger clinical trial.
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Affiliation(s)
- Steven Pratscher
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32611, USA; (S.P.); (J.G.M.); (A.J.J.); (R.P.); (R.B.F.)
- Department of Community of Dentistry, University of Florida, Gainesville, FL 32611, USA;
| | - Angela M. Mickle
- Department of Community of Dentistry, University of Florida, Gainesville, FL 32611, USA;
| | - John G. Marks
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32611, USA; (S.P.); (J.G.M.); (A.J.J.); (R.P.); (R.B.F.)
| | - Harold Rocha
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA; (H.R.); (F.B.); (S.G.); (A.K.)
| | - Felix Bartsch
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA; (H.R.); (F.B.); (S.G.); (A.K.)
| | - Jeffrey Schmidt
- College of Health Professions and Sciences, University of Central Florida, Orlando, FL 32816, USA;
| | - Lazaro Tejera
- Department of Interdisciplinary Medicine, University of Bari, 70125 Bari, Italy; (L.T.); (C.C.)
| | - Steven Garcia
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA; (H.R.); (F.B.); (S.G.); (A.K.)
| | - Carlo Custodero
- Department of Interdisciplinary Medicine, University of Bari, 70125 Bari, Italy; (L.T.); (C.C.)
| | - Federlin Jean
- Department of Aging & Geriatric Research, University of Florida, Gainesville, FL 32611, USA;
| | - Cynthia Garvan
- Department of Anesthesiology, University of Florida, Gainesville, FL 32611, USA;
| | - Alisa J. Johnson
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32611, USA; (S.P.); (J.G.M.); (A.J.J.); (R.P.); (R.B.F.)
- Department of Community of Dentistry, University of Florida, Gainesville, FL 32611, USA;
| | - Ralisa Pop
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32611, USA; (S.P.); (J.G.M.); (A.J.J.); (R.P.); (R.B.F.)
| | - Anthony Greene
- Counseling and Wellness Center, University of Florida, Gainesville, FL 32611, USA;
| | - Adam J. Woods
- Department of Clinical and Health Psychology, Center for Cognitive Aging and Memory Clinical Translational Research, University of Florida, Gainesville, FL 32611, USA;
| | - Roland Staud
- Department of Medicine, University of Florida, Gainesville, FL 32611, USA;
| | - Roger B. Fillingim
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32611, USA; (S.P.); (J.G.M.); (A.J.J.); (R.P.); (R.B.F.)
- Department of Community of Dentistry, University of Florida, Gainesville, FL 32611, USA;
| | - Andreas Keil
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA; (H.R.); (F.B.); (S.G.); (A.K.)
| | - Kimberly T. Sibille
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32611, USA; (S.P.); (J.G.M.); (A.J.J.); (R.P.); (R.B.F.)
- Department of Aging & Geriatric Research, University of Florida, Gainesville, FL 32611, USA;
- Department of Anesthesiology, University of Florida, Gainesville, FL 32611, USA;
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22
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Reckziegel D, Abdullah T, Wu B, Wu B, Huang L, Schnitzer TJ, Apkarian AV. Hippocampus shape deformation: a potential diagnostic biomarker for chronic back pain in women. Pain 2021; 162:1457-1467. [PMID: 33181581 PMCID: PMC8049947 DOI: 10.1097/j.pain.0000000000002143] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/03/2020] [Indexed: 02/06/2023]
Abstract
ABSTRACT Sex differences in the quality and prevalence of chronic pain are manifold, with women generally presenting higher incidence and severity. Uncovering chronic pain-related sex differences inform neural mechanisms and may lead to novel treatment routes. In a multicenter morphological study (total n = 374), we investigated whether the shape of subcortical regions would reflect sex differences in back pain. Given the hormone-dependent functions of the hippocampus, and its role in the transition to chronic pain, this region constituted our primary candidate. We found that the anterior part of the left hippocampus (alHP) presented outer deformation in women with chronic back pain (CBP), identified in CBP in the United States (n = 77 women vs n = 78 men) and validated in a Chinese data set (n = 29 women vs n = 58 men with CBP, in contrast to n = 53 female and n = 43 male healthy controls). Next, we examined this region in subacute back pain who persisted with back pain a year later (SBPp; n = 18 women vs n = 18 men) and in a subgroup with persistent back pain for 3 years. Weeks after onset of back pain, there was no deformation within alHP, but at 1 and 3 years women exhibited a trend for outer deformation. The alHP partly overlapped with the subiculum and entorhinal cortex, whose functional connectivity, in healthy subjects, was associated with emotional and episodic memory related terms (Neurosynth, reverse inference). These findings suggest that in women the alHP undergoes anatomical changes with pain persistence, highlighting sexually dimorphic involvement of emotional and episodic memory-related circuitry with chronic pain.
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Affiliation(s)
- Diane Reckziegel
- Center for Chronic Pain and Drug Abuse, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Taha Abdullah
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, USA
- Touro College of Osteopathic Medicine, New York, USA
| | - Binbin Wu
- Department of Pain Medicine, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Bo Wu
- Department of Information, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Lejian Huang
- Center for Chronic Pain and Drug Abuse, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Thomas J Schnitzer
- Center for Chronic Pain and Drug Abuse, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Rheumatology, Northwestern University, Feinberg School of Medicine, Chicago, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - A Vania Apkarian
- Center for Chronic Pain and Drug Abuse, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Anesthesia, Northwestern University Feinberg School of Medicine, Chicago, USA
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23
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Momentary pain assessments reveal benefits of endoscopic discectomy: a prospective cohort study. Pain Rep 2021; 6:e906. [PMID: 33981932 PMCID: PMC8108591 DOI: 10.1097/pr9.0000000000000906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 12/18/2020] [Accepted: 01/23/2021] [Indexed: 11/27/2022] Open
Abstract
Both pain rating and exponential model revealed that percutaneous endoscopic lumbar discectomy provided rapid pain recovery that was maintained for at least 3 months compared with conservative treatments. Lumbar disc herniation (LDH) is a common back disorder that evokes back and/or leg pain. Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive surgery for patients with LDH. However, there is little evidence of effectiveness of PELD compared with conservative treatments.
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24
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Barroso J, Wakaizumi K, Reis AM, Baliki M, Schnitzer TJ, Galhardo V, Apkarian AV. Reorganization of functional brain network architecture in chronic osteoarthritis pain. Hum Brain Mapp 2020; 42:1206-1222. [PMID: 33210801 PMCID: PMC7856636 DOI: 10.1002/hbm.25287] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/12/2020] [Accepted: 11/02/2020] [Indexed: 12/13/2022] Open
Abstract
Osteoarthritis (OA) manifests with chronic pain, motor impairment, and proprioceptive changes. However, the role of the brain in the disease is largely unknown. Here, we studied brain networks using the mathematical properties of graphs in a large sample of knee and hip OA (KOA, n = 91; HOA, n = 23) patients. We used a robust validation strategy by subdividing the KOA data into discovery and testing groups and tested the generalizability of our findings in HOA. Despite brain global topological properties being conserved in OA, we show there is a network wide pattern of reorganization that can be captured at the subject‐level by a single measure, the hub disruption index. We localized reorganization patterns and uncovered a shift in the hierarchy of network hubs in OA: primary sensory and motor regions and parahippocampal gyrus behave as hubs and insular cortex loses its central placement. At an intermediate level of network structure, frontoparietal and cingulo‐opercular modules showed preferential reorganization. We examined the association between network properties and clinical correlates: global disruption indices and isolated degree properties did not reflect clinical parameters; however, by modeling whole brain nodal degree properties, we identified a distributed set of regions that reliably predicted pain intensity in KOA and generalized to hip OA. Together, our findings reveal that while conserving global topological properties, brain network architecture reorganizes in OA, at both global and local scale. Network connectivity related to OA pain intensity is dissociated from the major hub disruptions, challenging the extent of dependence of OA pain on nociceptive signaling.
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Affiliation(s)
- Joana Barroso
- Departamento de Biomedicina, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde - i3S, Universidade do Porto, Porto, Portugal.,Department of Physical Medicine and Rehabilitation, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kenta Wakaizumi
- Shirley Ryan Ability Lab, Chicago, Illinois, USA.,Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan
| | | | - Marwan Baliki
- Department of Physical Medicine and Rehabilitation, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.,Shirley Ryan Ability Lab, Chicago, Illinois, USA
| | - Thomas J Schnitzer
- Department of Physical Medicine and Rehabilitation, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Internal Medicine/Rheumatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Anesthesia, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Vasco Galhardo
- Departamento de Biomedicina, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde - i3S, Universidade do Porto, Porto, Portugal
| | - Apkar Vania Apkarian
- Department of Physical Medicine and Rehabilitation, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Anesthesia, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
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25
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Yang L, Wu B, Fan L, Huang S, Vigotsky AD, Baliki MN, Yan Z, Apkarian AV, Huang L. Dissimilarity of functional connectivity uncovers the influence of participant's motion in functional magnetic resonance imaging studies. Hum Brain Mapp 2020; 42:713-723. [PMID: 33079467 PMCID: PMC7814752 DOI: 10.1002/hbm.25255] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 10/05/2020] [Accepted: 10/09/2020] [Indexed: 01/07/2023] Open
Abstract
Head motion is a major confounding factor impairing the quality of functional magnetic resonance imaging (fMRI) data. In particular, head motion can reduce analytical efficiency, and its effects are still present even after preprocessing. To examine the validity of motion removal and to evaluate the remaining effects of motion on the quality of the preprocessed fMRI data, a new metric of group quality control (QC), dissimilarity of functional connectivity, is introduced. Here, we investigate the association between head motion, represented by mean framewise displacement, and dissimilarity of functional connectivity by applying four preprocessing methods in two independent resting‐state fMRI datasets: one consisting of healthy participants (N = 167) scanned in a 3T GE‐Discovery 750 with longer TR (2.5 s), and the other of chronic back pain patients (N = 143) in a 3T Siemens Magnetom Prisma scanner with shorter TR (0.555 s). We found that dissimilarity of functional connectivity uncovers the influence of participant's motion, and this relationship is independent of population, scanner, and preprocessing method. The association between motion and dissimilarity of functional connectivity, and how the removal of high‐motion participants affects this association, is a new strategy for group‐level QC following preprocessing.
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Affiliation(s)
- Lili Yang
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bo Wu
- Department of Information, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Linyu Fan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shishi Huang
- Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Andrew D Vigotsky
- Departments of Biomedical Engineering and Statistics, Northwestern University, Evanston, Illinois, USA
| | - Marwan N Baliki
- Shirley Ryan AbilityLab, Chicago, Illinois, USA.,Department of Physical Management and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Zhihan Yan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - A Vania Apkarian
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Center for Translational Pain Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lejian Huang
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Center for Translational Pain Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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