Muthulingam Janusiya, Olesen Søren Schou, Hansen Tine Maria, Seminowicz David A, Burrowes Shana, Drewes Asbjørn Mohr, Frøkjær Jens Brøndum
Pancreas. 2018 Nov/Dec;47(10):1267-1276. doi: 10.1097/MPA.0000000000001151.
Temporal information about the structural brain changes in chronic pancreatitis (CP) and its relation to the clinical manifestations is lacking. This study investigated changes in morphological brain parameters over 7 years in painful CP patients, compared with controls.
In this 7-year longitudinal magnetic resonance imaging study, we included 23 CP patients and 14 controls. Gray matter volume (GMV) and cortical thickness were examined using voxel-based and surface-based morphometry. In addition, patients completed pain questionnaires and diary.
At baseline, patients had reduced GMV and cortical thickness in widespread brain areas compared with controls. After 7 years of follow-up, the GMV loss was more pronounced in patients compared with controls, particularly in precentral gyrus and putamen. Moreover, an increase in pain scores was associated with a less reduction of thalamic GMV (P = 0.046), whereas an increase in brief pain inventory score was associated with more reduction in cortical thickness of precentral (P = 0.005) and superior temporal gyri (P = 0.019), indicating that brain morphological alterations are associated with the pain.
Chronic pancreatitis pain is associated with morphological brain changes over time in several areas, reflecting that brain plasticity may be a consequence of repeated long-term nociceptive signaling.
目前缺乏关于慢性胰腺炎（CP）脑结构变化的时间信息及其与临床表现的关系。本研究调查了疼痛性CP患者7年期间脑形态学参数的变化，并与对照组进行比较。
在这项为期7年的纵向磁共振成像研究中，我们纳入了23例CP患者和14例对照。使用基于体素和基于表面的形态测量法检查灰质体积（GMV）和皮质厚度。此外，患者完成了疼痛问卷和日记。
在基线时，与对照组相比，患者在广泛的脑区中GMV和皮质厚度降低。经过7年的随访，与对照组相比，患者的GMV损失更为明显，特别是在中央前回和壳核。此外，疼痛评分的增加与丘脑GMV降低较少相关（P = 0.046），而简明疼痛量表评分的增加与中央前回（P = 0.005）和颞上回（P = 0.019）皮质厚度降低较多相关，表明脑形态学改变与疼痛相关。
慢性胰腺炎疼痛与多个脑区随时间的形态学变化相关，这反映出脑可塑性可能是反复长期伤害性信号传导的结果。
