Labus Jennifer S, Dinov Ivo D, Jiang Zhiguo, Ashe-McNalley Cody, Zamanyan Alen, Shi Yonggang, Hong Jui-Yang, Gupta Arpana, Tillisch Kirsten, Ebrat Bahar, Hobel Sam, Gutman Boris A, Joshi Shantanu, Thompson Paul M, Toga Arthur W, Mayer Emeran A
Oppenheimer Family Center for Neurobiology of Stress, Pain and Interoception Network (PAIN), David Geffen School of Medicine at UCLA, Los Angeles, CA, USA Laboratory of Neuro Imaging (LONI), Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, USA Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, USA.
Pain. 2014 Jan;155(1):137-149. doi: 10.1016/j.pain.2013.09.020. Epub 2013 Sep 26.
Alterations in gray matter (GM) density/volume and cortical thickness (CT) have been demonstrated in small and heterogeneous samples of subjects with differing chronic pain syndromes, including irritable bowel syndrome (IBS). Aggregating across 7 structural neuroimaging studies conducted at University of California, Los Angeles, Los Angeles, CA, USA, between August 2006 and April 2011, we examined group differences in regional GM volume in 201 predominantly premenopausal female subjects (82 IBS, mean age: 32±10 SD, 119 healthy controls [HCs], 30±10 SD). Applying graph theoretical methods and controlling for total brain volume, global and regional properties of large-scale structural brain networks were compared between the group with IBS and the HC group. Relative to HCs, the IBS group had lower volumes in the bilateral superior frontal gyrus, bilateral insula, bilateral amygdala, bilateral hippocampus, bilateral middle orbital frontal gyrus, left cingulate, left gyrus rectus, brainstem, and left putamen. Higher volume was found in the left postcentral gyrus. Group differences were no longer significant for most regions when controlling for the Early Trauma Inventory global score, with the exception of the right amygdala and the left postcentral gyrus. No group differences were found for measures of global and local network organization. Compared to HCs, in patients with IBS, the right cingulate gyrus and right thalamus were identified as being significantly more critical for information flow. Regions involved in endogenous pain modulation and central sensory amplification were identified as network hubs in IBS. Overall, evidence for central alterations in patients with IBS was found in the form of regional GM volume differences and altered global and regional properties of brain volumetric networks.
在患有不同慢性疼痛综合征(包括肠易激综合征,IBS)的受试者的小样本且异质性的样本中,已证实灰质(GM)密度/体积和皮质厚度(CT)存在改变。汇总2006年8月至2011年4月在美国加利福尼亚州洛杉矶市的加利福尼亚大学洛杉矶分校进行的7项结构性神经影像学研究,我们检查了201名主要为绝经前女性受试者(82名IBS患者,平均年龄:32±10标准差,119名健康对照者[HCs],30±10标准差)区域GM体积的组间差异。应用图论方法并控制全脑体积,比较了IBS组和HC组之间大规模结构性脑网络的全局和区域属性。相对于HCs,IBS组在双侧额上回、双侧岛叶、双侧杏仁核、双侧海马、双侧眶额中回、左侧扣带回、左侧直回、脑干和左侧壳核的体积较小。在左侧中央后回发现体积较大。在控制早期创伤量表全球评分后,大多数区域的组间差异不再显著,但右侧杏仁核和左侧中央后回除外。在全局和局部网络组织测量方面未发现组间差异。与HCs相比,在IBS患者中,右侧扣带回和右侧丘脑被确定为对信息流更为关键。参与内源性疼痛调节和中枢感觉放大的区域被确定为IBS中的网络枢纽。总体而言,以区域GM体积差异以及脑容积网络的全局和区域属性改变的形式,发现了IBS患者中枢改变的证据。