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静息态功能连接可预测纤维肌痛综合征患者接受运动皮层刺激后的疼痛缓解。

Resting-state functional connectivity predicts motor cortex stimulation-dependent pain relief in fibromyalgia syndrome patients.

机构信息

Clinical Neurophysiology Lab, Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.

Department of Neurology, Rambam Health Care Campus, Haifa, Israel.

出版信息

Sci Rep. 2022 Oct 12;12(1):17135. doi: 10.1038/s41598-022-21557-x.


DOI:10.1038/s41598-022-21557-x
PMID:36224244
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9556524/
Abstract

MRI-based resting-state functional connectivity (rsFC) has been shown to predict response to pharmacological and non-pharmacological treatments for chronic pain, but not yet for motor cortex transcranial magnetic stimulation (M1-rTMS). Twenty-seven fibromyalgia syndrome (FMS) patients participated in this double-blind, crossover, and sham-controlled study. Ten daily treatments of 10 Hz M1-rTMS were given over 2 weeks. Before treatment series, patients underwent resting-state fMRI and clinical pain evaluation. Significant pain reduction occurred following active, but not sham, M1-rTMS. The following rsFC patterns predicted reductions in clinical pain intensity after the active treatment: weaker rsFC of the default-mode network with the middle frontal gyrus (r = 0.76, p < 0.001), the executive control network with the rostro-medial prefrontal cortex (r = 0.80, p < 0.001), the thalamus with the middle frontal gyrus (r = 0.82, p < 0.001), and the pregenual anterior cingulate cortex with the inferior parietal lobule (r = 0.79, p < 0.001); and stronger rsFC of the anterior insula with the angular gyrus (r =  - 0.81, p < 0.001). The above regions process the attentional and emotional aspects of pain intensity; serve as components of the resting-state networks; are modulated by rTMS; and are altered in FMS. Therefore, we suggest that in FMS, the weaker pre-existing interplay between pain-related brain regions and networks, the larger the pain relief resulting from M1-rTMS.

摘要

基于磁共振成像的静息态功能连接(rsFC)已被证明可预测慢性疼痛的药物和非药物治疗反应,但尚未预测运动皮层经颅磁刺激(M1-rTMS)的反应。27 名纤维肌痛综合征(FMS)患者参与了这项双盲、交叉和假对照研究。在 2 周内进行了 10 天的 10 Hz M1-rTMS 治疗。在治疗系列之前,患者接受了静息态 fMRI 和临床疼痛评估。在接受主动治疗后,疼痛明显减轻,但假治疗组则无明显减轻。以下 rsFC 模式预测了主动治疗后临床疼痛强度的降低:默认模式网络与中额回之间的 rsFC 减弱(r=0.76,p<0.001),执行控制网络与额内侧前额叶皮质之间的 rsFC 增强(r=0.80,p<0.001),丘脑与中额回之间的 rsFC 增强(r=0.82,p<0.001),以及前扣带皮质与下顶叶之间的 rsFC 增强(r=0.79,p<0.001);以及前岛叶与角回之间的 rsFC 减弱(r= - 0.81,p<0.001)。上述区域处理疼痛强度的注意力和情绪方面;作为静息态网络的组成部分;受 rTMS 调节;并在 FMS 中发生改变。因此,我们认为在 FMS 中,与疼痛相关的大脑区域和网络之间预先存在的相互作用较弱,M1-rTMS 引起的疼痛缓解越大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3aab/9556524/ebf8e270ea3d/41598_2022_21557_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3aab/9556524/8fd04735a56e/41598_2022_21557_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3aab/9556524/43db39018267/41598_2022_21557_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3aab/9556524/ebf8e270ea3d/41598_2022_21557_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3aab/9556524/8fd04735a56e/41598_2022_21557_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3aab/9556524/43db39018267/41598_2022_21557_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3aab/9556524/ebf8e270ea3d/41598_2022_21557_Fig3_HTML.jpg

相似文献

[1]
Resting-state functional connectivity predicts motor cortex stimulation-dependent pain relief in fibromyalgia syndrome patients.

Sci Rep. 2022-10-12

[2]
Clinical Effects of Repetitive Transcranial Magnetic Stimulation of the Motor Cortex Are Associated With Changes in Resting-State Functional Connectivity in Patients With Fibromyalgia Syndrome.

J Pain. 2022-4

[3]
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[4]
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[5]
Resting state connectivity correlates with drug and placebo response in fibromyalgia patients.

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[6]
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[7]
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[8]
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[9]
Changes in brain connectivity during a sham-controlled, transcranial magnetic stimulation trial for depression.

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[10]
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引用本文的文献

[1]
Brain modulatory effects of rehabilitation interventions in fibromyalgia: a systematic review of magnetic resonance imaging studies.

Neurol Sci. 2025-5

[2]
Nociplastic Pain: A Critical Paradigm for Multidisciplinary Recognition and Management.

J Clin Med. 2024-9-26

[3]
Repetitive Transcranial Magnetic Stimulation in Fibromyalgia: Exploring the Necessity of Neuronavigation for Targeting New Brain Regions.

J Pers Med. 2024-6-20

[4]
Three weeks of exercise therapy altered brain functional connectivity in fibromyalgia inpatients.

Neurobiol Pain. 2023-5-19

本文引用的文献

[1]
Structural and functional thalamocortical connectivity study in female fibromyalgia.

Sci Rep. 2021-12-2

[2]
Clinical Effects of Repetitive Transcranial Magnetic Stimulation of the Motor Cortex Are Associated With Changes in Resting-State Functional Connectivity in Patients With Fibromyalgia Syndrome.

J Pain. 2022-4

[3]
The Medial Thalamus Plays an Important Role in the Cognitive and Emotional Modulation of Orofacial Pain: A Functional Magnetic Resonance Imaging-Based Study.

Front Neurol. 2021-1-21

[4]
A picture is worth a thousand words: linking fibromyalgia pain widespreadness from digital pain drawings with pain catastrophizing and brain cross-network connectivity.

Pain. 2021-5-1

[5]
The anterior and medial thalamic nuclei and the human limbic system: tracing the structural connectivity using diffusion-weighted imaging.

Sci Rep. 2020-7-2

[6]
Altered resting-state functional connectivity between subregions in the thalamus and cortex in migraine without aura.

Eur J Neurol. 2020-11

[7]
Neural correlates of conditioned pain responses in fibromyalgia subjects indicate preferential formation of new pain associations rather than extinction of irrelevant ones.

Pain. 2020-9-1

[8]
Default mode network changes in fibromyalgia patients are largely dependent on current clinical pain.

Neuroimage. 2020-8-1

[9]
Modulating Brain Networks With Transcranial Magnetic Stimulation Over the Primary Motor Cortex: A Concurrent TMS/fMRI Study.

Front Hum Neurosci. 2020-2-14

[10]
The Endogenous Analgesia Signature in the Resting Brain of Healthy Adults and Migraineurs.

J Pain. 2020

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