Li Jin-Ling, Yan Chao-Qun, Wang Xu, Zhang Shuai, Zhang Na, Hu Shang-Qing, Wang Li-Qiong, Liu Cun-Zhi
School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine, Beijing, People's Republic of China.
Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China.
J Pain Res. 2020 Mar 20;13:575-583. doi: 10.2147/JPR.S220370. eCollection 2020.
Chronic shoulder pain (CSP) is a common health problem associated with shoulder dysfunction and persistent pain for many different reasons. However, the studies of pain-related functional brain regions in CSP have been poorly investigated. The main purpose of our study was to observe whether there are abnormal functional changes in brain regions in patients with CSP by using functional magnetic resonance imaging (fMRI).
We compared the differences of brain regions between 37 patients with CSP and 24 healthy controls (HC) using regional homogeneity (ReHo) method. The patients with chronic shoulder pain and healthy controls were matched for age and gender. Brain regions which had abnormal ReHo values were defined as seed region of interests. The approach of seed-based functional connectivity (FC) was further performed to analyze the connectivity between the seeds and whole brain regions. The relationship between abnormal regions and current clinical pain was also evaluated.
Compared to healthy controls, the patients with CSP showed increased ReHo values in the left middle temporal gyrus and decreased ReHo values in right orbitofrontal cortex (OFC). The seed-based analyses demonstrated decreased connectivity between the right OFC and right rectus, superior frontal gyrus in patients with chronic shoulder pain. However, a correlation between ReHo values and clinical characteristics in CSP patients was not found.
The observed results indicate that there are abnormal ReHo values in brain regions of patients with CSP, especially in the OFC and middle temporal gyrus. Our findings demonstrate that the experience of CSP patients may be mainly associated with cognitive-affective pain processing, rather than nociception.
慢性肩痛（CSP）是一个常见的健康问题，因多种不同原因与肩部功能障碍和持续性疼痛相关。然而，关于CSP中与疼痛相关的功能性脑区的研究却很少。我们研究的主要目的是通过功能磁共振成像（fMRI）观察CSP患者脑区是否存在异常功能变化。
我们使用局部一致性（ReHo）方法比较了37例CSP患者和24名健康对照者（HC）之间脑区的差异。慢性肩痛患者和健康对照者在年龄和性别上相匹配。ReHo值异常的脑区被定义为感兴趣的种子区域。进一步采用基于种子的功能连接（FC）方法分析种子区域与全脑区域之间的连接性。还评估了异常区域与当前临床疼痛之间的关系。
与健康对照者相比，CSP患者左侧颞中回的ReHo值升高，右侧眶额皮质（OFC）的ReHo值降低。基于种子的分析表明，慢性肩痛患者右侧OFC与右侧直肌、额上回之间的连接性降低。然而，未发现CSP患者的ReHo值与临床特征之间存在相关性。
观察结果表明，CSP患者脑区存在异常的ReHo值，尤其是在OFC和颞中回。我们的研究结果表明，CSP患者的体验可能主要与认知-情感性疼痛处理有关，而非伤害感受。
