Department of Radiology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, China.
Department of Critical Care Medicine, the Third Affiliated Hospital (The First People's Hospital of Zunyi) of Zunyi Medical University, Zunyi, Guizhou, China.
Pain Physician. 2021 Aug;24(5):E601-E610.
Despite previous reports on cerebral structures and functional connectivity in patients with myofascial pain (MFP), it is not clear whether alterations in neurovascular coupling occur in these patients.
We analyzed the coupling between resting-state cerebral blood flow (CBF) and functional connectivity strength (FCS) for observation of neurovascular coupling in patients with chronic MFP.
Observational study.
University hospital.
Resting-state functional magnetic resonance imaging and arterial spin labeling were performed in 23 patients with chronic MFP and 23 healthy controls (HC) for the calculation of FCS and CBF. The whole-brain gray matter CBF-FCS correlations and CBF/FCS ratios of the various voxels of the 2 groups were subsequently compared.
Compared with the HC, the patients with MFP experienced a decrease in whole-brain gray matter CBF-FCS coupling. In patients with MFP, a decrease in CBF/FCS was found in the bilateral superior temporal gyri, right parahippocampal gyrus, right hippocampus, caudate nucleus, right medial prefrontal cortex, and the periaqueductal gray matter (PAG), whereas an increase in CBF/FCS was found in the bilateral lingual gyri, posterior cingulate cortex, and bilateral inferior parietal lobules. In addition, the CBF/FCS of the PAG in patients with MFP was significantly negatively correlated with the pain visual analog scale score and pain duration.
Alterations in neurovascular coupling in patients with MFP were observed only before treatment. Therefore, there is a lack of data on the alterations that occurred after treatment.
This study demonstrated for the first time that impairment of neurovascular coupling in the brain may be a potential neuropathological mechanism of chronic MFP.
尽管先前有研究报告了肌筋膜疼痛（MFP）患者的脑结构和功能连接，但目前尚不清楚这些患者是否存在神经血管耦合的改变。
我们分析了慢性 MFP 患者静息状态脑血流（CBF）与功能连接强度（FCS）之间的耦合，以观察神经血管耦合情况。
观察性研究。
大学医院。
对 23 例慢性 MFP 患者和 23 例健康对照者（HC）进行静息态功能磁共振成像和动脉自旋标记，以计算 FCS 和 CBF。随后比较了两组各体素的全脑灰质 CBF-FCS 相关和 CBF/FCS 比值。
与 HC 相比，MFP 患者的全脑灰质 CBF-FCS 耦合降低。MFP 患者的 CBF/FCS 降低见于双侧颞上回、右侧海马旁回、右侧海马、尾状核、右侧内侧前额叶和中脑导水管周围灰质（PAG），而 CBF/FCS 升高见于双侧舌回、后扣带回和双侧顶下小叶。此外，MFP 患者 PAG 的 CBF/FCS 与疼痛视觉模拟评分和疼痛持续时间呈显著负相关。
仅在治疗前观察到 MFP 患者神经血管耦合的改变。因此，缺乏治疗后发生改变的数据。
本研究首次证明，大脑中神经血管耦合的损害可能是慢性 MFP 的潜在神经病理学机制。
