China-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Pain. 2019 Dec;160(12):2829-2840. doi: 10.1097/j.pain.0000000000001674.
Brain functional network properties are globally disrupted in multiple musculoskeletal chronic pain conditions. Back pain with lumbar disk herniation (LDH) is highly prevalent and a major route for progression to chronic back pain. However, brain functional network properties remain unknown in such patients. Here, we examined resting-state functional magnetic resonance imaging-based functional connectivity networks in chronic back pain patients with clear evidence for LDH (LDH-chronic pain n = 146), in comparison to healthy controls (HCs, n = 165). The study was conducted in China, thus providing the opportunity to also examine the influence of culture on brain functional reorganization with chronic pain. The data were equally subdivided into discovery and validation subgroups (n = 68 LDH-chronic pain and n = 68 HC, for each subgroup), and contrasted to an off-site data set (n = 272, NITRC 1000). Graph disruption indices derived from 3 network topological measurements, degree, clustering coefficient, and efficiency, which respectively represent network hubness, segregation, and integration, were significantly decreased compared with HC, across all predefined link densities, in both discovery and validation groups. However, global mean clustering coefficient and betweenness centrality were decreased in the discovery group and showed trend in the validation group. The relationship between pain and graph disruption indices was limited to males with high education. These results deviate somewhat from recent similar analysis for other musculoskeletal chronic pain conditions, yet we cannot determine whether the differences are due to types of pain or also to cultural differences between patients studied in China and the United States.
大脑功能网络特性在多种肌肉骨骼慢性疼痛病症中普遍受到破坏。腰椎间盘突出症(LDH)相关的腰痛患病率很高,并且是进展为慢性腰痛的主要途径。然而,此类患者的大脑功能网络特性仍不清楚。在这里,我们研究了有明确 LDH 证据的慢性腰痛患者(LDH-慢性疼痛组,n=146)与健康对照者(HC,n=165)的静息态功能磁共振成像(rs-fMRI)功能连接网络。该研究在中国进行,因此提供了机会来研究文化对慢性疼痛患者大脑功能重组的影响。数据同样分为发现和验证子组(n=68 LDH-慢性疼痛和 n=68 HC,每个子组),并与异地数据(n=272,NITRC 1000)进行对比。从 3 种网络拓扑测量(度、聚类系数和效率)得出的图形破坏指数分别代表网络中心度、分离度和整合度,与 HC 相比,在所有预设的连接密度下,发现组和验证组的所有患者的这些指数均显著降低。然而,在发现组中,全局平均聚类系数和介数中心度降低,而在验证组中则呈趋势。疼痛与图形破坏指数之间的关系仅局限于高学历的男性。这些结果与其他肌肉骨骼慢性疼痛病症的最近类似分析有些不同,但我们尚不能确定这些差异是由于疼痛类型不同,还是由于在中国和美国研究的患者之间存在文化差异。
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