Ni Xixiu, Zhang Jiabao, Sun Mingsheng, Wang Linjia, Xu Tao, Zeng Qian, Wang Xiao, Wang Ziwen, Liao Huaqiang, Hu Yimei, Gao Qing, Zhao Ling
Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, China.
Front Mol Neurosci. 2022 Jun 29;15:880228. doi: 10.3389/fnmol.2022.880228. eCollection 2022.
: Chronic neck pain (CNP) is highly prevalent and complicated, associated with limited movement, and accompanied by shoulder pain and other clinical manifestations such as dizziness, anxiety, and insomnia. Brain structural and functional abnormalities often occur in patients with CNP. However, knowledge of the brain's functional organization and temporal dynamics in CNP patients is limited. Dynamic functional connectivity density (dFCD) can reflect the ability of brain areas or voxels to integrate information, and could become neuroimaging markers for objectively reflecting pain to a certain extent. Therefore, this study compared the dFCD between CNP patients and healthy controls (HCs) and investigated potential associations of the abnormal density variability in dynamic functional connectivity with pain characteristics in CNP patients. : Resting functional magnetic resonance imaging was performed for 89 CNP patients and 57 HCs. After preprocessing resting-state fMRI images by the Data Processing and Analysis of Brain Imaging toolbox, the sliding window method was applied to investigate dFCD changes in CNP patients and HCs using the DynamicBC toolbox. Then we quantified dFCD variability using their standard deviation. Based on the pain-associated factors collected from the case report form of CNP patients, the mean dFCD variability values of each dFCD from region of interest were extracted to calculate Pearson's correlation coefficient to study the potential correlation between dFCD abnormal variability and pain. : Compared with HCs, the dFCD values of the anterior cingulate cortex, occipital lobe, temporal lobe, and cerebellum were statistically different in patients with CNP. Subsequent correlation analysis showed that the variable dFCD in the related brain region was correlative with the course of the disease and clinical symptoms, such as pain and depression, in patients with CNP. : Dynamic functional alterations were observed in the brain regions of CNP patients, and the dFCD of these brain regions could become neuroimaging markers for objectively reflecting pain to a certain extent. This suggests that chronic pain may cause changes in pain processing and emotional feedback and highlights the link between dynamic neural communication in brain regions and disease conditions, deepening our understanding of chronic pain diseases, and guiding clinical practice.
慢性颈痛（CNP）非常普遍且复杂，与活动受限相关，并伴有肩部疼痛以及头晕、焦虑和失眠等其他临床表现。CNP患者常出现脑结构和功能异常。然而，关于CNP患者大脑功能组织和时间动态的了解有限。动态功能连接密度（dFCD）可以反映脑区或体素整合信息的能力，并在一定程度上可成为客观反映疼痛的神经影像学标志物。因此，本研究比较了CNP患者与健康对照（HCs）之间的dFCD，并调查了动态功能连接中异常密度变异性与CNP患者疼痛特征的潜在关联。
对89例CNP患者和57例HCs进行静息态功能磁共振成像。使用脑成像数据处理与分析工具箱对静息态功能磁共振成像图像进行预处理后，应用滑动窗口法，使用DynamicBC工具箱研究CNP患者和HCs的dFCD变化。然后我们使用标准差量化dFCD变异性。根据从CNP患者病例报告表中收集的疼痛相关因素，提取感兴趣区域每个dFCD的平均dFCD变异性值，计算皮尔逊相关系数，以研究dFCD异常变异性与疼痛之间的潜在相关性。
与HCs相比，CNP患者前扣带回皮质、枕叶、颞叶和小脑的dFCD值存在统计学差异。随后的相关分析表明，相关脑区的可变dFCD与CNP患者的病程以及疼痛和抑郁等临床症状相关。
在CNP患者的脑区观察到动态功能改变，这些脑区的dFCD在一定程度上可成为客观反映疼痛的神经影像学标志物。这表明慢性疼痛可能导致疼痛处理和情绪反馈的变化，并突出了脑区动态神经通信与疾病状态之间的联系，加深了我们对慢性疼痛疾病的理解，并指导临床实践。
