Wang Aibo, Chen Lei, Tian Can, Yin Xiaoyu, Wang Xinyue, Zhao Yize, Zhang Miao, Yang Lili, Ye Zhaoxiang
Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
National Clinical Research Center for Cancer, Tianjin, China.
Front Neurosci. 2022 Mar 4;16:823701. doi: 10.3389/fnins.2022.823701. eCollection 2022.
Cancer pain (CP) is one of the most common symptoms affecting life quality, and there is considerable variation in pain experience among patients with malignant tumors. Previously, it has been found that the fluid drainage function in the brain can be regulated by peripheral pain stimulation. However, the relationship between cancer pain and functional changes of the glymphatic system (an important pathway for fluid drainage in the brain) remains unclear. In this study, 97 participants were enrolled, which included 40 participants in the cancer pain (CP) group, 27 participants in the painless cancer (PLC) group and 30 participants in the control (NC) group. Differences in glymphatic system function among the three groups and between before and after pain pharmacological intervention were analyzed by measuring diffusivity and the index along the perivascular space (ALPS index) using diffusion tensor imaging. We found that diffusivity and the ALPS index were significantly lower in the CP group than in the PLC and NC group and increased following intervention with pain relief. Moreover, the ALPS index was negatively correlated with the degree of pain in the CP group. The present study verified that alterations in glymphatic function are closely related to cancer pain, and the quantification of functional changes reflects pain severity. Our findings support the use of neuroimaging biomarkers for cancer pain assessment and indicate that pain can be alleviated by regulating brain function status.
癌痛（CP）是影响生活质量的最常见症状之一，恶性肿瘤患者的疼痛体验存在很大差异。此前，已发现外周疼痛刺激可调节脑内的液体引流功能。然而，癌痛与脑淋巴系统（脑内液体引流的重要途径）功能变化之间的关系仍不清楚。本研究招募了97名参与者，其中癌痛（CP）组40名，无痛癌症（PLC）组27名，对照组（NC）组30名。通过使用扩散张量成像测量扩散率和沿血管周围间隙的指数（ALPS指数），分析三组之间以及疼痛药物干预前后脑淋巴系统功能的差异。我们发现，CP组的扩散率和ALPS指数显著低于PLC组和NC组，且在疼痛缓解干预后有所增加。此外，CP组的ALPS指数与疼痛程度呈负相关。本研究证实，脑淋巴功能改变与癌痛密切相关，功能变化的量化反映了疼痛严重程度。我们的研究结果支持使用神经影像学生物标志物进行癌痛评估，并表明通过调节脑功能状态可以缓解疼痛。
