Zhou Fuqing, Gu Lili, Hong Shunda, Liu Jiaqi, Jiang Jian, Huang Muhua, Zhang Yong, Gong Honghan
Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, People's Republic of China.
Neuroradiology Laboratory, Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi, People's Republic of China.
J Pain Res. 2018 Jan 9;11:165-176. doi: 10.2147/JPR.S151562. eCollection 2018.
The aim of this study was to explore the amplitude of intrinsic low-frequency oscillations (LFOs) in patients with discogenic low-back and leg pain (LBLP).
We obtained and compared the LFO amplitude from 25 right-handed discogenic LBLP patients (13 males; mean age 55.16±1.83 years) and 27 well-matched healthy controls (15 males; mean age 52.96±1.63 years). The LFO amplitude was examined using the voxel-wise amplitude of low-frequency fluctuations (ALFFs), and partial correlation analysis was performed to determine the relationship between the regions with altered ALFF values and clinical parameters in discogenic LBLP patients.
Compared with healthy controls, the patients with discogenic LBLP showed a significant increase in ALFF in the affective system of the pain matrix (left anterior cingulate cortex, right anterior insula/frontal operculum, and bilateral orbitofrontal cortex) and information-processing regions (middle occipital/temporal gyrus). In addition, a significant decrease in ALFF was observed in the default mode network (DMN; inferior parietal lobule (IPL) and medial prefrontal cortex [mPFC]) and the processing system of the pain matrix (basal ganglia/thalamus/midbrain, postcentral gyrus [PoCG], and fusiform gyrus). Several regions with altered ALFF were associated with disease duration, visual analog scale scores, Barthel index, and fine sensory modality measurements (two-point tactile discrimination of the left and/or right leg). Further operating characteristic curves analysis suggested that the mean ALFF values in the right IPL, left IPL/PoCG, left anterior cingulate cortex, and left mPFC could serve as markers to separate individuals with discogenic LBLP from healthy subjects.
Our results revealed widespread abnormalities in ALFF in the pain matrix and information-processing regions as well as a decrease in ALFF in the DMN. These results open up an important new avenue to better understand the nature of the link between intrinsic activity and peripheral pain and sensory impairment in discogenic LBLP patients.
本研究旨在探讨椎间盘源性下腰腿痛（LBLP）患者内在低频振荡（LFOs）的振幅。
我们获取并比较了25例右利手椎间盘源性LBLP患者（13例男性；平均年龄55.16±1.83岁）和27例匹配良好的健康对照者（15例男性；平均年龄52.96±1.63岁）的LFO振幅。使用体素低频波动幅度（ALFFs）检查LFO振幅，并进行偏相关分析以确定ALFF值改变区域与椎间盘源性LBLP患者临床参数之间的关系。
与健康对照者相比，椎间盘源性LBLP患者在疼痛矩阵的情感系统（左侧前扣带回皮质、右侧前脑岛/额下回和双侧眶额皮质）和信息处理区域（枕中/颞回）的ALFF显著增加。此外，在默认模式网络（DMN；顶下小叶（IPL）和内侧前额叶皮质[mPFC]）以及疼痛矩阵的处理系统（基底神经节/丘脑/中脑、中央后回[PoCG]和梭状回）中观察到ALFF显著降低。几个ALFF改变的区域与病程、视觉模拟评分、Barthel指数以及精细感觉模态测量（左和/或右腿的两点触觉辨别）相关。进一步的操作特征曲线分析表明，右侧IPL、左侧IPL/PoCG、左侧前扣带回皮质和左侧mPFC的平均ALFF值可作为区分椎间盘源性LBLP患者与健康受试者的标志物。
我们的结果揭示了疼痛矩阵和信息处理区域中ALFF广泛异常以及DMN中ALFF降低。这些结果为更好地理解内在活动与椎间盘源性LBLP患者外周疼痛和感觉障碍之间联系的本质开辟了一条重要的新途径。
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