磁共振波谱在慢性疼痛障碍中的应用：一项系统综述方案，旨在综合慢性疼痛患者的解剖和代谢物研究结果。
Magnetic resonance spectroscopy across chronic pain disorders: a systematic review protocol synthesising anatomical and metabolite findings in chronic pain patients.
机构信息
Department of Anaesthesia, Intensive Care and Pain Medicine, St. Vincent's University Hospital, Dublin 4, Ireland.
Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland.
出版信息
Syst Rev. 2019 Dec 27;8(1):338. doi: 10.1186/s13643-019-1256-5.
BACKGROUND
Chronic pain is pain greater than 3 months duration that may result from disease, trauma, surgery, or unknown origin. The overlap between the psychological, behavioural, and management aspects of pain suggest that limbic brain neurochemistry plays a role in chronic pain pathology. Proton magnetic resonance spectroscopy (H-MRS) can evaluate in vivo brain metabolites including creatine, N-acetylaspartate, myo-inositol, choline, glutamate, glutamine, and gamma-aminobutyric acid in chronic pain; however, a comprehensive systemic review of metabolite expression patterns across all brain areas has yet to be performed.
METHODS AND ANALYSIS
Online databases including PubMed/MEDLINE, Google Scholar, EMBASE, the Cochrane Library, OVID, and PsycINFO will be searched for articles relating to H-MRS and chronic pain. Study inclusion criteria will include ages of between 18 and 65 years with a definite diagnosis of chronic pain, no comorbidities, clearly stated brain volumes of interest, and imaging protocols, with comparisons to healthy controls. Two reviewers will extract data relating to volumes of interest, metabolites, study participant demographics, diagnostic method and pain scores, treatments and duration of treatment, scanner information, H-MRS acquisition protocols, and spectral processing software. Where possible, volumes of interest will be reassigned as regions of interest consistent with known regional anatomical and functional properties to increase the power and relevance of the analysis. Statistical analyses will then be conducted using STATA. A central common pathway may exist for chronic pain due to the behavioural manifestations and management similarities between its different types. The goal of this systemic review is to generate a comprehensive neurochemical theory of chronic pain in different brain compartments.
SYSTEMATIC REVIEW REGISTRATION
This study is registered with PROSPERO CRD42018112640.
背景
慢性疼痛是指持续时间超过 3 个月的疼痛，可能由疾病、创伤、手术或未知原因引起。疼痛的心理、行为和管理方面存在重叠，这表明边缘脑神经化学在慢性疼痛病理中发挥作用。质子磁共振波谱（H-MRS）可评估包括肌酸、N-乙酰天冬氨酸、肌醇、胆碱、谷氨酸、谷氨酰胺和γ-氨基丁酸在内的活体脑代谢物，用于慢性疼痛；然而，尚未对所有脑区的代谢物表达模式进行全面的系统综述。
方法和分析
将在在线数据库（包括 PubMed/MEDLINE、Google Scholar、EMBASE、Cochrane 图书馆、OVID 和 PsycINFO）中搜索与 H-MRS 和慢性疼痛相关的文章。纳入标准为年龄在 18 至 65 岁之间，有明确的慢性疼痛诊断，无合并症，明确的感兴趣脑区和成像方案，以及与健康对照组的比较。两名评审员将提取与感兴趣脑区、代谢物、研究参与者人口统计学、诊断方法和疼痛评分、治疗和治疗持续时间、扫描仪信息、H-MRS 采集方案和光谱处理软件相关的数据。在可能的情况下，将感兴趣脑区重新分配为与已知区域解剖和功能特性一致的感兴趣区域，以提高分析的效力和相关性。然后将使用 STATA 进行统计分析。由于不同类型的慢性疼痛具有行为表现和管理相似性，因此可能存在一个中央共同通路。本系统综述的目的是生成不同脑区慢性疼痛的综合神经化学理论。
系统综述注册
本研究在 PROSPERO CRD42018112640 中进行了注册。
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