Zhao Zhiyong, Huang Tianming, Tang Chaozheng, Ni Kaiji, Pan Xiandi, Yan Chao, Fan Xiaoduo, Xu Dongrong, Luo Yanli
MOE & Shanghai Key Laboratory of Brain Functional Genomics (East China Normal University), Institute of Cognitive Neuroscience, Shanghai Key Laboratory of Magnetic Resonance Institute of Cognitive Neuroscience, East China Normal University, Shanghai, China.
Department of General Psychiatry, Shanghai Changning Mental Health Center, Shanghai, China.
PLoS One. 2017 Apr 28;12(4):e0176494. doi: 10.1371/journal.pone.0176494. eCollection 2017.
Patients with persistent somatoform pain disorder (PSPD) usually experience various functional impairments in pain, emotion, and cognition, which cannot be fully explained by a physiological process or a physical disorder. However, it is still not clear for the mechanism underlying the pathogenesis of PSPD. The present study aimed to explore the intra- and inter-network functional connectivity (FC) differences between PSPD patients and healthy controls (HCs). Functional magnetic resonance imaging (fMRI) was performed in 13 PSPD patients and 23 age- and gender-matched HCs. We used independent component analysis on resting-state fMRI data to calculate intra- and inter-network FCs, and we used the two-sample t-test to detect the FC differences between groups. Spearman correlation analysis was employed to evaluate the correlations between FCs and clinical assessments. As compared to HCs, PSPD patients showed decreased coactivations in the right superior temporal gyrus within the anterior default-mode network and the anterior cingulate cortex within the salience network, and increased coactivations in the bilateral supplementary motor areas within the sensorimotor network and both the left posterior cingulate cortex and the medial prefrontal cortex within the anterior default-mode network. In addition, we found that the PSPD patients showed decreased FNCs between sensorimotor network and audio network as well as visual network, between default-mode network and executive control network as well as audio network and between salience network and executive control network as well as right frontoparietal network, and increased FNCs between sensorimotor network and left frontoparietal network, salience network as well as cerebellum network, which were negatively correlated with the clinical assessments in PSPD patients. Our findings suggest that PSPD patients experience large-scale reorganization at the level of the functional networks, which suggests a possible mechanism underlying the pathogenesis of PSPD.
持续性躯体形式疼痛障碍（PSPD）患者通常在疼痛、情绪和认知方面经历各种功能障碍，这些障碍无法完全由生理过程或躯体疾病来解释。然而，PSPD发病机制背后的机制仍不清楚。本研究旨在探讨PSPD患者与健康对照（HCs）之间网络内和网络间的功能连接（FC）差异。对13例PSPD患者和23例年龄及性别匹配的HCs进行了功能磁共振成像（fMRI）检查。我们对静息态fMRI数据进行独立成分分析以计算网络内和网络间的FC，并使用两样本t检验来检测组间的FC差异。采用Spearman相关分析来评估FC与临床评估之间的相关性。与HCs相比，PSPD患者在前默认模式网络中的右侧颞上回和突显网络中的前扣带回皮质的共激活减少，而在感觉运动网络中的双侧辅助运动区以及前默认模式网络中的左侧后扣带回皮质和内侧前额叶皮质的共激活增加。此外，我们发现PSPD患者在感觉运动网络与听觉网络以及视觉网络之间、默认模式网络与执行控制网络以及听觉网络之间、突显网络与执行控制网络以及右侧额顶网络之间的功能连接（FNC）减少，而在感觉运动网络与左侧额顶网络、突显网络以及小脑网络之间的FNC增加，这些与PSPD患者的临床评估呈负相关。我们的研究结果表明，PSPD患者在功能网络水平上经历了大规模重组，这提示了PSPD发病机制的一种可能机制。
