Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Antwerp, Belgium.
Department of Radiology, Antwerp University Hospital, Antwerp, Belgium.
Anat Rec (Hoboken). 2024 Feb;307(2):285-297. doi: 10.1002/ar.25113. Epub 2022 Nov 7.
The purpose of this study was to perform a systematic review of the available literature on morphological and functional brain changes measured by modern neuroimaging techniques in patients suffering from chronic cancer-related pain. A systematic search was conducted in PubMed, Embase, and Web of Science using different keyword combinations. In addition, a hand search was performed on the reference lists and several databases to retrieve supplementary primary studies. Eligible articles were assessed for methodological quality and risk of bias and reviewed by two independent researchers. The search yielded only four studies, three of which used MRI and one PET-CT. None of the studies measured longitudinal morphological (i.e., gray or white matter) changes. All studies investigated functional brain changes and found differences in specific brain regions and networks between patients with chronic cancer-related pain and pain-free cancer patients or healthy volunteers. Some of these alterations were found in brain networks that also show changes in non-cancer populations with chronic pain (e.g., the default mode network and salience network). However, specific findings were inconsistent, and there was substantial variation in imaging methodology, analysis, sample size, and study quality. There is a striking lack of research on morphological brain changes in patients with chronic cancer-related pain. Moreover, only a few studies investigated functional brain changes. In the retrieved studies, there is some evidence that alterations occur in brain networks also involved in other chronic non-cancer pain syndromes. However, the low sample sizes of the studies, finding inconsistencies, and methodological heterogeneity do not allow for robust conclusions.
本研究旨在通过现代神经影像学技术对患有慢性癌症相关疼痛的患者进行形态和功能脑变化的系统综述。我们在 PubMed、Embase 和 Web of Science 中使用不同的关键词组合进行了系统搜索。此外，还在手检参考文献和几个数据库中检索补充的原始研究。对合格的文章进行了方法学质量和偏倚风险评估，并由两名独立研究人员进行了审查。搜索结果仅显示了四项研究，其中三项使用了 MRI，一项使用了 PET-CT。没有一项研究测量纵向形态学（即灰质或白质）变化。所有研究都调查了功能脑变化，并发现慢性癌症相关疼痛患者与无疼痛癌症患者或健康志愿者之间特定脑区和网络存在差异。这些改变中的一些存在于慢性疼痛的非癌症人群中也会发生改变的脑网络中（例如，默认模式网络和突显网络）。然而，具体发现不一致，并且影像学方法、分析、样本量和研究质量存在很大差异。目前，关于慢性癌症相关疼痛患者形态学脑变化的研究非常少。此外，只有少数研究调查了功能脑变化。在检索到的研究中，有一些证据表明，在涉及其他慢性非癌症疼痛综合征的脑网络中也会发生改变。然而，研究样本量小、发现不一致以及方法学异质性使得无法得出可靠的结论。
