Hu Yingxuan, Ma Junqin, Chen Bingmei, Pang Jiahui, Liang Wen, Wu Wen
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China.
Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China.
J Pain Res. 2024 May 27;17:1941-1951. doi: 10.2147/JPR.S457575. eCollection 2024.
This study was conducted to explore the differences in functional changes in the pain matrix in patients with chronic back pain (CBP) at different stages and identify whether these brain changes were related to the pain duration.
In this study, 29 healthy individuals and 54 patients with CBP were recruited. According to the pain duration, 25 patients (3 to 12 months) were divided into the CBP-S group and 29 patients (≥ 24 months) were divided into the CBP-L group. All subjects completed clinical pain-related measurement and functional magnetic resonance imaging (fMRI) scans. Moreover, the amplitude of low-frequency fluctuation (ALFF), functional connectivity (FC), and correlation analysis were conducted in this study.
Compared with healthy controls, patients in the CBP-L group showed significantly decreased ALFF in the left precuneus. In the FC analysis, patients in the CBP-S and CBP-L groups showed significantly decreased FC in several regions in the bilateral orbitofrontal cortices (OFC) and the left ventral posterior insula. Moreover, there were significant differences in the FC between the left hyper granular insula and the probabilistic area in OFC in pairwise group comparisons. The correlation analysis results demonstrated that pain duration was correlated with these functional brain changes, and the ANCOVA results revealed that pain intensity and pain interference scores did not affect the FC analysis results.
There are different changes in the pain neural matrix in patients with chronic pain at different stages. Furthermore, the pain duration is related to brain functional changes.
本研究旨在探讨慢性背痛（CBP）患者不同阶段疼痛矩阵功能变化的差异，并确定这些脑区变化是否与疼痛持续时间相关。
本研究招募了29名健康个体和54名CBP患者。根据疼痛持续时间，25名患者（3至12个月）分为CBP-S组，29名患者（≥24个月）分为CBP-L组。所有受试者均完成临床疼痛相关测量及功能磁共振成像（fMRI）扫描。此外，本研究还进行了低频振幅（ALFF）、功能连接（FC）及相关性分析。
与健康对照组相比，CBP-L组患者左侧楔前叶的ALFF显著降低。在FC分析中，CBP-S组和CBP-L组患者双侧眶额皮质（OFC）及左侧腹侧后岛叶的多个区域FC显著降低。此外，在两两分组比较中，左侧颗粒状岛叶与OFC概率区域之间的FC存在显著差异。相关性分析结果表明，疼痛持续时间与这些脑功能变化相关，协方差分析结果显示疼痛强度和疼痛干扰评分不影响FC分析结果。
慢性疼痛患者不同阶段的疼痛神经矩阵存在不同变化。此外，疼痛持续时间与脑功能变化相关。
