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膝关节骨关节炎治疗患者皮质活动的功能变化:一项探索性初步研究。

Functional Changes in Cortical Activity of Patients Submitted to Knee Osteoarthritis Treatment: An Exploratory Pilot Study.

机构信息

From the Center of Acupuncture, Department of Orthopaedics and Traumatology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil (LRI); Centro de Pesquisa Clinica, Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil (LRI, MI, KS, MS, LRB); Hospital das Clínicas, Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil (AM); and Spaulding Neuromodulation Center, Spaulding Rehabilitation Center and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (FF).

出版信息

Am J Phys Med Rehabil. 2022 Oct 1;101(10):920-930. doi: 10.1097/PHM.0000000000001931. Epub 2021 Nov 18.

Abstract

INTRODUCTION

There is evidence that brain plasticity is the central mechanism involved in the functional recovery process of patients with knee osteoarthritis. Studies involving the analysis of central nervous system mechanisms of pain control and recovery could provide more data on future therapeutic approaches.

OBJECTIVE

The aim of the study was to explore possible functional changes in cortical activity of patients submitted to knee osteoarthritis standardized pain treatment using electroencephalography.

METHODOLOGY

Ten patients with clinical and radiological diagnosis of painful knee unilateral or bilateral osteoarthritis were recruited to participate in clinical (Pain's Visual Analog Scale), radiological (Kellgren-Lawrence Scale), and neurophysiological (electroencephalography) assessments to evaluate cortical activity during cortical pain modulation activity. The clinical and neurophysiological analyses were performed before and after standardized pain treatment.

RESULTS

Eight patients participated in this study. A significant improvement in pain perception and relative increase in interhemispheric connectivity after therapies was observed. In electroencephalography analysis, tests with real movement showed a relative increase in density directed at Graph's analysis.

CONCLUSIONS

Relative increase density directed measures at connectivity analysis in electroencephalography after pain treatment can be possible parameters to be explored in future research with a larger number of patients.

摘要

简介

有证据表明,大脑的可塑性是膝关节骨关节炎患者功能恢复过程中涉及的核心机制。涉及疼痛控制和恢复的中枢神经系统机制的研究可以为未来的治疗方法提供更多数据。

目的

本研究旨在通过脑电图探索膝关节骨关节炎标准化疼痛治疗后患者皮质活动的可能功能变化。

方法

招募了 10 名单侧或双侧膝关节骨关节炎疼痛的临床和放射学诊断患者参与临床(疼痛视觉模拟量表)、放射学(Kellgren-Lawrence 量表)和神经生理学(脑电图)评估,以评估皮质疼痛调节活动期间的皮质活动。在标准化疼痛治疗前后进行临床和神经生理分析。

结果

8 名患者参与了这项研究。治疗后观察到疼痛感知显著改善和大脑两半球间连通性相对增加。在脑电图分析中,实际运动测试显示,针对 Graph 分析的密度定向相对增加。

结论

疼痛治疗后脑电图中连接性分析的相对密度定向测量可能是未来对更多患者进行研究的探索参数。

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