Zheng Jin Hua, Sun Wen Hua, Ma Jian Jun, Wang Zhi Dong, Chang Qing Qing, Dong Lin Rui, Shi Xiao Xue, Li Ming Jian
Department of Neurology, Henan Provincial People's Hospital, Weiwu Road, Building 7, Zhengzhou, 450003, Henan Province, People's Republic of China.
Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China.
Pain Ther. 2022 Sep;11(3):959-970. doi: 10.1007/s40122-022-00404-x. Epub 2022 Jun 25.
Pain in Parkinson's disease is poorly understood, and most patients with pain do not respond to dopaminergic drugs. We aimed to explore the mechanisms of dopa-responsive and -unresponsive pain by comparing such patients against patients without pain in terms of neural activity and functional connectivity in the brain.
We prospectively examined 31 Parkinson's patients with dopa-responsive pain, 51 with dopa-unresponsive pain and 93 without pain using resting-state functional magnetic resonance imaging. Neural activity was assessed in terms of the amplitude of low-frequency fluctuation, while functional connectivity was assessed based on analysis of regions of interest.
Patients with dopa-unresponsive pain showed significantly higher amplitude of low-frequency fluctuation in the right parahippocampal/lingual region than patients with no pain. However, there was no amplitude difference between the dopa-responsive pain group and the no pain group. Patients with dopa-unresponsive pain also differed significantly from patients with no pain in their functional connections between the superior temporal gyrus and other areas of cerebral cortex, between amygdala and thalamus and between the amygdala and putamen. Patients with dopa-responsive pain differed significantly from patients with no pain in their functional connections between temporal fusiform cortex and cerebellum, between precentral gyrus and temporal fusiform cortex and between precentral gyrus and cerebellum.
Regional neural activity and functional connectivity in the brain differ substantially among Parkinson's patients with dopa-unresponsive pain, dopa-responsive pain or no pain. Our results suggest that dopa-responsive and -unresponsive pain may arise through different mechanisms, which may help guide the development of targeted therapies.
帕金森病中的疼痛尚不清楚，大多数疼痛患者对多巴胺能药物无反应。我们旨在通过比较帕金森病伴疼痛患者与无疼痛患者在大脑神经活动和功能连接方面的差异，来探究多巴胺反应性疼痛和无反应性疼痛的机制。
我们使用静息态功能磁共振成像对31例有多巴胺反应性疼痛的帕金森病患者、51例有多巴胺无反应性疼痛的患者和93例无疼痛的患者进行了前瞻性研究。通过低频波动幅度评估神经活动，同时基于感兴趣区域分析评估功能连接。
多巴胺无反应性疼痛患者右侧海马旁/舌回区域的低频波动幅度显著高于无疼痛患者。然而，多巴胺反应性疼痛组与无疼痛组之间在低频波动幅度上没有差异。多巴胺无反应性疼痛患者在颞上回与大脑皮质其他区域、杏仁核与丘脑以及杏仁核与壳核之间的功能连接也与无疼痛患者有显著差异。多巴胺反应性疼痛患者在颞梭状回与小脑、中央前回与颞梭状回以及中央前回与小脑之间的功能连接与无疼痛患者有显著差异。
在有多巴胺无反应性疼痛、多巴胺反应性疼痛或无疼痛的帕金森病患者中，大脑区域神经活动和功能连接存在显著差异。我们的结果表明，多巴胺反应性疼痛和无反应性疼痛可能通过不同机制产生，这可能有助于指导靶向治疗的开发。
