Napadow Vitaly, Harris Richard E
Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA.
Arthritis Res Ther. 2014;16(5):425. doi: 10.1186/s13075-014-0425-0.
Research suggests that fibromyalgia is a central, widespread pain syndrome supported by a generalized disturbance in central nervous system pain processing. Over the past decades, multiple lines of research have identified the locus for many functional, chronic pain disorders to the central nervous system, and the brain. In recent years, brain neuroimaging techniques have heralded a revolution in our understanding of chronic pain, as they have allowed researchers to non-invasively (or minimally invasively) evaluate human patients suffering from various pain disorders. While many neuroimaging techniques have been developed, growing interest in two specific imaging modalities has led to significant contributions to chronic pain research. For instance, resting functional connectivity magnetic resonance imaging (fcMRI) is a recent adaptation of fMRI that examines intrinsic brain connectivity - defined as synchronous oscillations of the fMRI signal that occurs in the resting basal state. Proton magnetic resonance spectroscopy (1H-MRS) is a non-invasive magnetic resonance imaging technique that can quantify the concentration of multiple metabolites within the human brain. This review will outline recent applications of the complementary imaging techniques - fcMRI and 1H-MRS - to improve our understanding of fibromyalgia pathophysiology and how pharmacological and non-pharmacological therapies contribute to analgesia in these patients. A better understanding of the brain in chronic pain, with specific linkage as to which neural processes relate to spontaneous pain perception and hyperalgesia, will greatly improve our ability to develop novel therapeutics. Neuroimaging will play a growing role in the translational research approaches needed to make this a reality.
研究表明，纤维肌痛是一种中枢性、广泛性疼痛综合征，由中枢神经系统疼痛处理的普遍紊乱所支持。在过去几十年中，多条研究路线已将许多功能性慢性疼痛障碍的发病部位确定到中枢神经系统和大脑。近年来，脑成像技术在我们对慢性疼痛的理解方面引发了一场革命，因为它们使研究人员能够以非侵入性（或微创性）方式评估患有各种疼痛障碍的人类患者。虽然已经开发了许多神经成像技术，但对两种特定成像方式的兴趣日益浓厚，这为慢性疼痛研究做出了重大贡献。例如，静息功能连接磁共振成像（fcMRI）是功能磁共振成像（fMRI）的最新变体，它研究大脑的内在连接性，即静息基础状态下发生的fMRI信号的同步振荡。质子磁共振波谱（1H-MRS）是一种非侵入性磁共振成像技术，可量化人脑中多种代谢物的浓度。本综述将概述互补成像技术——fcMRI和1H-MRS的最新应用，以增进我们对纤维肌痛病理生理学的理解，以及药物和非药物疗法如何对这些患者产生镇痛作用。更好地理解慢性疼痛中的大脑，特别是将哪些神经过程与自发疼痛感知和痛觉过敏联系起来，将极大地提高我们开发新疗法的能力。神经成像将在实现这一目标所需的转化研究方法中发挥越来越重要的作用。
