Ge Shengyang, Hu Qingfeng, Xia Guowei, Tan Yifan, Guo Yijun, Sun Chuanyu
Department of Urology, Huashan Hospital, Fudan University, 12 Urumqi Middle Rd., Shanghai 200040, China.
Department of Urology, Jing'an District Central Hospital, Fudan University, 259 Xikang Rd., Shanghai 200040, China.
Brain Sci. 2022 Oct 4;12(10):1344. doi: 10.3390/brainsci12101344.
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a challenging entity with complicated symptoms for treatment in the male crowd. Accumulating evidence revealed the dysfunction in the central system should be a critical factor for the pathogenesis and development in the CP/CPPS. Therefore, we recruited 20 patients of CP/CPPS and 20 healthy male volunteers, aged 20 to 50 years. Through resting-state functional magnetic resonance imaging (fMRI), we analyzed the mean amplitude of low-frequency fluctuations (mALFF) and the mean fractional amplitude of low-frequency fluctuations (mfALFF) to reflect the spontaneous abnormal activated regions in the brains of CP/CPPS patients. Compared to the healthy controls, the group with CP/CPPS had significantly increased mALFF values in the thalamus and augmented fALFF values in the inferior parietal lobule and cingulate gyrus. Significant positive correlations were observed in the extracted mALFF values in the midbrain periaqueductal gray matter (PAG) and the pain intensity ( = 0.2712, = 0.0019), mALFF values in the thalamus and the scores of Hospital Anxiety and Depression Scale (HADS) anxiety subscale ( = 0.08477, = 0.0461), and mfALFF values in the superior frontal gyrus (SFG) and the scores of the HADS anxiety subscale ( = 0.07102, = 0.0282). Therefore, we delineated the clinical alterations in patients of CP/CPPS that might be attributed to the functional abnormality of the thalamus, inferior parietal lobule, and cingulate gyrus. Among these regions, the PAG, thalamus, and SFG may further play an important role in the pathogenesis, with their regulating effect on pain or emotion.
慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）是男性群体中一种治疗症状复杂且具有挑战性的病症。越来越多的证据表明，中枢系统功能障碍应是CP/CPPS发病机制和病情发展的关键因素。因此，我们招募了20例CP/CPPS患者和20名年龄在20至50岁之间的健康男性志愿者。通过静息态功能磁共振成像（fMRI），我们分析了低频振幅（mALFF）和低频分数振幅（mfALFF），以反映CP/CPPS患者大脑中的自发异常激活区域。与健康对照组相比，CP/CPPS组丘脑的mALFF值显著升高，顶下小叶和扣带回的fALFF值增大。在中脑导水管周围灰质（PAG）提取的mALFF值与疼痛强度之间观察到显著正相关（r = 0.2712，P = 0.0019），丘脑的mALFF值与医院焦虑抑郁量表（HADS）焦虑分量表得分之间（r = 0.08477，P = 0.0461），以及额上回（SFG）的mfALFF值与HADS焦虑分量表得分之间（r = 0.07102，P = 0.0282）。因此，我们描绘了CP/CPPS患者可能归因于丘脑、顶下小叶和扣带回功能异常的临床改变。在这些区域中，PAG、丘脑和SFG可能在发病机制中进一步发挥重要作用，对疼痛或情绪具有调节作用。
