School of Medical Sciences and Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia.
Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia.
J Neurosci Res. 2022 Jul;100(7):1487-1505. doi: 10.1002/jnr.25057. Epub 2022 Apr 20.
Complex regional pain syndrome (CRPS) is a painful condition commonly accompanied by movement disturbances and often affects the upper limbs. The basal ganglia motor loop is central to movement, however, non-motor basal ganglia loops are involved in pain, sensory integration, visual processing, cognition, and emotion. Systematic evaluation of each basal ganglia functional loop and its relation to motor and non-motor disturbances in CRPS has not been investigated. We recruited 15 upper limb CRPS and 45 matched healthy control subjects. Using functional magnetic resonance imaging, infraslow oscillations (ISO) and resting-state functional connectivity in motor and non-motor basal ganglia loops were investigated using putamen and caudate seeds. Compared to controls, CRPS subjects displayed increased ISO power in the putamen contralateral to the CRPS affected limb, specifically, in contralateral putamen areas representing the supplementary motor area hand, motor hand, and motor tongue. Furthermore, compared to controls, CRPS subjects displayed increased resting connectivity between these putaminal areas as well as from the caudate body to cortical areas such as the primary motor cortex, supplementary and cingulate motor areas, parietal association areas, and the orbitofrontal cortex. These findings demonstrate changes in basal ganglia loop function in CRPS subjects and may underpin motor disturbances of CRPS.
复杂性区域疼痛综合征(CRPS)是一种常见的伴有运动障碍的疼痛病症,通常影响上肢。基底神经节运动回路是运动的核心,但非运动基底神经节回路参与疼痛、感觉整合、视觉处理、认知和情绪。CRPS 中每个基底神经节功能回路及其与运动和非运动障碍的关系尚未进行系统评估。我们招募了 15 名上肢 CRPS 患者和 45 名匹配的健康对照组。使用功能磁共振成像,使用纹状体和尾状核种子研究运动和非运动基底神经节回路中的亚慢振荡(ISO)和静息状态功能连接。与对照组相比,CRPS 患者在 CRPS 受累肢体对侧的纹状体中显示出 ISO 功率增加,特别是在代表辅助运动区手、运动手和运动舌的对侧纹状体区域。此外,与对照组相比,CRPS 患者显示这些纹状体区域之间以及从尾状核体到皮质区域(如初级运动皮层、补充和扣带运动区域、顶叶联合区域和眶额叶皮层)的静息连接增加。这些发现表明 CRPS 患者的基底神经节回路功能发生变化,可能是 CRPS 运动障碍的基础。
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