Ma Teng, Ji Yuan-Yuan, Yan Lin-Feng, Lin Jia-Ji, Li Ze-Yang, Wang Wen, Li Jin-Lian, Cui Guang-Bin
Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
College of Forensic Medicine, Xi'an Jiaotong University, Xi'an, China.
Front Neurosci. 2022 Jun 6;16:826759. doi: 10.3389/fnins.2022.826759. eCollection 2022.
Gray matter volume (GMV) alteration in specific brain regions has been widely regarded as one of the most important neuroplasticity features in chronic pain patients with depressive symptoms (CP-D). However, the consistent and significant results were still lacking. Thus, further exploration was suggested to be performed.
This study aimed to comprehensively collect the voxel-based morphometry (VBM) studies on GMV alteration between CP-D and healthy controls (HCs). And a systemic review and meta-analysis were made to explore the characteristic brain regions in chronic pain and depression comorbidity.
Search of PubMed, MEDLINE, Web of Science, and Cochrane Library databases updated to July 13, 2021. The altered GMV between CP-D and HCs in VBM studies was included in this meta-analysis. In total, 18 studies (20 datasets) and 1320 participants (520 patients and 800 HCs) were included. The significant coordinate information (, , ) reported in standard space and the effect size (value or -score) were extracted and analyzed by anisotropic effect size-signed differential mapping (AES-SDM) 5.15 software.
According to the main analysis results, CP-D showed significant and consistent increased GMV in the left hippocampus (HIP. L) and decreased GMV in the medial part of the left superior frontal gyrus (SFG. L, BA 10) compared to HCs. Subgroup analysis showed significant decreased GMV in the medial orbital part of SFG.R (BA 10) in neuropathic pain, as well as significant increased GMV in the right parahippocampal gyrus (PHG.R, BA 35), left hippocampus (HIP.L, BA 20), and right middle frontal gyrus (MFG.R) in musculoskeletal pain. Furthermore, meta-regression showed a positive relationship between the decreased GMV in the medial part of SFG.L and the percentage of female patients.
GMV abnormality in specific brain areas (e.g., HIP.L and SFG) was robust and reproducible, which could be significantly involved in this comorbidity disease. The findings in this study may be a valuable reference for future research.
特定脑区灰质体积（GMV）改变被广泛认为是伴有抑郁症状的慢性疼痛患者（CP-D）最重要的神经可塑性特征之一。然而，仍缺乏一致且显著的结果。因此，建议进行进一步探索。
本研究旨在全面收集基于体素的形态学测量（VBM）研究中CP-D与健康对照（HCs）之间GMV改变的情况。并进行系统评价和荟萃分析，以探索慢性疼痛与抑郁共病的特征性脑区。
检索截至2021年7月13日更新的PubMed、MEDLINE、Web of Science和Cochrane图书馆数据库。VBM研究中CP-D与HCs之间GMV的改变纳入本荟萃分析。总共纳入18项研究（20个数据集）和1320名参与者（520例患者和800名HCs）。在标准空间中报告的显著坐标信息（x、y、z）和效应大小（t值或z分数）通过各向异性效应大小符号差异映射（AES-SDM）5.15软件进行提取和分析。
根据主要分析结果，与HCs相比，CP-D在左侧海马体（HIP.L）中GMV显著且一致增加，在左侧额上回内侧部分（SFG.L，BA 10）中GMV降低。亚组分析显示，在神经性疼痛中，右侧额上回眶内侧部分（SFG.R，BA 10）的GMV显著降低，在肌肉骨骼疼痛中，右侧海马旁回（PHG.R，BA 35）、左侧海马体（HIP.L，BA 20）和右侧额中回（MFG.R）的GMV显著增加。此外，荟萃回归显示左侧额上回内侧部分GMV降低与女性患者比例之间呈正相关。
特定脑区（如HIP.L和SFG）的GMV异常是稳定且可重复的，可能与这种共病密切相关。本研究结果可能为未来研究提供有价值的参考。
