Health Service Center, Hiroshima University, Minami-Ku, Hiroshima, Japan; Center for Brain, Mind and KANSEI Sciences Research, Hiroshima University, Minami-Ku, Hiroshima, Japan.
Center for Brain, Mind and KANSEI Sciences Research, Hiroshima University, Minami-Ku, Hiroshima, Japan.
J Pain. 2024 Aug;25(8):104523. doi: 10.1016/j.jpain.2024.104523. Epub 2024 Apr 4.
Cognitive behavioral therapy (CBT) is believed to be an effective treatment for chronic pain due to its association with cognitive and emotional factors. Nevertheless, there is a paucity of magnetoencephalography (MEG) investigations elucidating its underlying mechanisms. This study investigated the neurophysiological effects of CBT employing MEG and analytical techniques. We administered resting-state MEG scans to 30 patients with chronic pain and 31 age-matched healthy controls. Patients engaged in a 12-session group CBT program. We conducted pretreatment (T1) and post-treatment (T2) MEG and clinical assessments. MEG data were examined within predefined regions of interest, guided by the authors' and others' prior magnetic resonance imaging studies. Initially, we selected regions displaying significant changes in power spectral density and multiscale entropy between patients at T1 and healthy controls. Then, we examined the changes within these regions after conducting CBT. Furthermore, we applied support vector machine analysis to MEG data to assess the potential for classifying treatment effects. We observed normalization of power in the gamma2 band (61-90 Hz) within the right inferior frontal gyrus (IFG) and multiscale entropy within the right dorsolateral prefrontal cortex (DLPFC) of patients with chronic pain after CBT. Notably, changes in pain intensity before and after CBT positively correlated with the alterations of multiscale entropy. Importantly, responders predicted by the support vector machine classifier had significantly higher treatment improvement rates than nonresponders. These findings underscore the pivotal role of the right IFG and DLPFC in ameliorating pain intensity through CBT. Further accumulation of evidence is essential for future applications. PERSPECTIVE: We conducted MEG scans on 30 patients with chronic pain before and after a CBT program, comparing results with 31 healthy individuals. There were CBT-related changes in the right IFG and DLPFC. These results highlight the importance of specific brain regions in pain reduction through CBT.
认知行为疗法(CBT)被认为是治疗慢性疼痛的有效方法,因为它与认知和情绪因素有关。然而,目前利用脑磁图(MEG)研究其潜在机制的研究还很少。本研究采用 MEG 和分析技术研究 CBT 的神经生理效应。我们对 30 名慢性疼痛患者和 31 名年龄匹配的健康对照者进行了静息状态 MEG 扫描。患者接受了 12 节小组 CBT 课程。我们在治疗前(T1)和治疗后(T2)进行 MEG 和临床评估。MEG 数据是根据作者和其他人之前的磁共振成像研究,在预先定义的感兴趣区域内进行检查的。最初,我们选择了在 T1 时患者和健康对照组之间功率谱密度和多尺度熵有显著变化的区域。然后,我们在进行 CBT 后检查了这些区域内的变化。此外,我们还将支持向量机分析应用于 MEG 数据,以评估分类治疗效果的潜力。我们观察到慢性疼痛患者右额下回(IFG)和右背外侧前额叶皮层(DLPFC)中的伽马 2 带(61-90 Hz)的功率恢复正常,以及多尺度熵恢复正常。值得注意的是,CBT 前后疼痛强度的变化与多尺度熵的变化呈正相关。重要的是,支持向量机分类器预测的应答者的治疗改善率明显高于无应答者。这些发现强调了右 IFG 和 DLPFC 在通过 CBT 改善疼痛强度方面的关键作用。未来的应用需要进一步积累证据。观点:我们对 30 名接受 CBT 前后的慢性疼痛患者和 31 名健康个体进行了 MEG 扫描,比较了结果。右 IFG 和 DLPFC 有 CBT 相关的变化。这些结果突出了特定脑区在 CBT 降低疼痛中的重要性。