Feliu-Soler Albert, Martínez-Zalacaín Ignacio, Pérez-Aranda Adrián, Borràs Xavier, Andrés-Rodríguez Laura, Sanabria-Mazo Juan P, Fayed Nicolás, Stephan-Otto Christian, Núñez Christian, Soriano-Mas Carles, Luciano Juan V
Institut de Recerca Sant Joan de Déu, 08950 Esplugues de Llobregat, Spain.
Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, 08830 St. Boi de Llobregat, Spain.
J Clin Med. 2020 Jan 30;9(2):374. doi: 10.3390/jcm9020374.
This study explored the brain structural correlates of psychological flexibility (PF) as measured with the Psychological Inflexibility in Pain Scale (PIPS) in patients with fibromyalgia (FM). Structural magnetic resonance imaging data from 47 FM patients were used to identify Gray Matter Volume (GMV) alterations related to PIPS scores. Brain GMV clusters related to PIPS were then correlated with clinical and cognitive variables to further explore how emerged brain clusters were intertwined with FM symptomatology. Longitudinal changes in PIPS-related brain clusters values were assessed by studying pre-post data from 30 patients (15 allocated to a mindfulness-based stress reduction (MBSR) program and 15 to treatment-as-usual). Changes in PIPS-related brain clusters were also explored in participants showing greater/lower longitudinal changes in PIPS scores. PIPS scores were positively associated with GMV in a bilateral cluster in the ventral part of the bed nucleus of the stria terminalis (BNST). Significant associations between BNST cluster with functional impairment, depressive symptomatology, perceived stress and the nonjudging mindfulness facet were observed. Participants reporting greater pre-post increases in PIPS scores showed greater increases in BNST cluster values. These findings contribute to the understanding on the neurobiological bases of PF in FM and encourage further explorations of the role of the BNST in chronic pain.
本研究探讨了纤维肌痛（FM）患者中，用疼痛心理僵化量表（PIPS）测量的心理灵活性（PF）与脑结构的相关性。来自47名FM患者的结构磁共振成像数据用于识别与PIPS评分相关的灰质体积（GMV）改变。然后将与PIPS相关的脑GMV簇与临床和认知变量进行关联，以进一步探索出现的脑簇如何与FM症状相互交织。通过研究30名患者（15名分配到基于正念减压（MBSR）计划，15名接受常规治疗）的前后数据，评估与PIPS相关的脑簇值的纵向变化。在PIPS评分纵向变化较大/较小的参与者中，也探讨了与PIPS相关的脑簇的变化。PIPS评分与终纹床核（BNST）腹侧双侧簇中的GMV呈正相关。观察到BNST簇与功能损害、抑郁症状、感知压力和非评判性正念方面之间存在显著关联。报告PIPS评分前后增加较大的参与者，其BNST簇值增加也更大。这些发现有助于理解FM中PF的神经生物学基础，并鼓励进一步探索BNST在慢性疼痛中的作用。
