Kim Jae-Hun, Choi Soo-Hee, Jang Joon Hwan, Lee Do-Hyeong, Lee Kyung-Jun, Lee Won Joon, Moon Jee Youn, Kim Yong Chul, Kang Do-Hyung
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
PLoS One. 2017 Jul 10;12(7):e0180479. doi: 10.1371/journal.pone.0180479. eCollection 2017.
Given that the insula plays a contributory role in the perception of chronic pain, we examined the resting-state functional connectivity between the insular cortex and other brain regions to investigate neural underpinnings of persisting perception of background pain in patients with complex regional pain syndrome (CRPS). A total of 25 patients with CRPS and 25 matched healthy controls underwent functional magnetic resonance imaging at rest. With the anterior and posterior insular cortices as seed regions, we compared the strength of the resting-state functional connectivity between the two groups. Functional connectivity between the anterior and posterior insular cortices and the postcentral and inferior frontal gyri, cingulate cortices was reduced in patients with CRPS compared with controls. Additionally, greater reductions in functional connectivity between the anterior insula and right postcentral gyrus were associated with more severe sensory pain in patients with CRPS (short-form McGill Pain Questionnaire sensory subscores, r = -.517, P = .023). The present results imply a possible role of the insula in aberrant processing of pain information in patients with CRPS. The findings suggest that a functional derangement of the connection between one of the somatosensory cortical functions of perception and one of the insular functions of awareness can play a significant role in the persistent experience of regional pain that is not confined to a specific nerve territory.
鉴于脑岛在慢性疼痛感知中起作用，我们研究了脑岛皮质与其他脑区之间的静息态功能连接，以探究复杂区域疼痛综合征（CRPS）患者持续性背景疼痛感知的神经基础。共有25例CRPS患者和25名匹配的健康对照者接受了静息态功能磁共振成像检查。以前岛和后岛皮质作为种子区域，我们比较了两组之间静息态功能连接的强度。与对照组相比，CRPS患者前岛和后岛皮质与中央后回、额下回、扣带回皮质之间的功能连接减弱。此外，CRPS患者前岛与右侧中央后回之间功能连接的更大程度减弱与更严重的感觉性疼痛相关（简式麦吉尔疼痛问卷感觉子评分，r = -0.517，P = 0.023）。目前的结果表明脑岛在CRPS患者疼痛信息的异常处理中可能起作用。这些发现表明，在不限于特定神经区域的局部疼痛的持续体验中，感觉皮层感知功能与脑岛意识功能之一之间连接的功能紊乱可能起重要作用。
