Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China; Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Pain Physician. 2024 Jul;27(5):E557-E566.
Abnormalities of structural and functional brain regions might influence the persistence of knee pain, the progression, and the response to treatments in knee osteoarthritis (KOA). These complex alterations present a challenge to the understanding of its mechanism.
To meta-analyze the concurrence across structural and functional magnetic resonance imaging studies.
Systematic review and meta-analysis.
This meta-analysis examined all voxel-based morphometric (VBM) and amplitude of low-frequency fluctuation (ALFF) studies involving the whole-brain alterations of KOA.
VBM and ALFF studies published up to May 7, 2023, were searched in the Web of Science, PubMed, EMBASE, Cochrane Library (CENTRAL), China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database, Chongqing VIP, Wanfang Database. Two independent researchers carried out study screening, quality assessment, clinical data extraction, and neuroimaging data extraction. The whole-brain voxel-based gray matter (GM) and brain activity data of KOA were collected from eligible studies and meta-analyzed using the anisotropic effect size-signed differential mapping (AES-SDM).
Fourteen studies were included in this study. In VBM meta-analyses, a total of 481 patients were enrolled in this study (252 KOA and 229 healthy patients). In the ALFF meta-analysis, a total of 518 patients were enrolled in this study (265 KOA and 253 healthy patients). According to the meta-analysis, KOA had increased GM volume in the right inferior frontal gyrus and decreased GM volume in the bilateral superior frontal gyrus, as well as increased brain activity in the left inferior frontal gyrus and inferior temporal gyrus, and decreased brain activity in the left middle occipital gyrus, right supramarginal gyrus, right superior frontal gyrus, and right superior parietal gyrus compared with healthy patients.
Most of the ALFF studies included in this meta-analysis were conducted in China. Our findings are exclusively addressed by the VBM and ALFF studies. The meta-regression between the duration of KOA, pain intensity and abnormal gray matter, and functional activity of brain regions in patients with KOA were unable to be analyzed.
The results of this meta-analysis indicate that patients with KOA present significant abnormalities in GM volume and functional activity. These findings contribute to a better understanding of the structural and functional abnormalities seen in patients with KOA.
结构和功能脑区的异常可能会影响膝关节骨关节炎（KOA）患者的膝关节疼痛持续时间、进展和对治疗的反应。这些复杂的改变给其发病机制的理解带来了挑战。
对结构和功能磁共振成像研究进行荟萃分析。
系统评价和荟萃分析。
本荟萃分析研究了所有全脑容积形态学（VBM）和低频振幅（ALFF）研究中 KOA 的全脑改变。
检索了截至 2023 年 5 月 7 日在 Web of Science、PubMed、EMBASE、Cochrane 图书馆（CENTRAL）、中国知网（CNKI）、中国生物医学文献数据库、重庆维普、万方数据库中的 VBM 和 ALFF 研究。两位独立的研究者进行了研究筛选、质量评估、临床数据提取和神经影像学数据提取。从合格的研究中收集 KOA 的全脑体素灰质（GM）和脑活动数据，并使用各向异性效应大小差异映射（AES-SDM）进行荟萃分析。
本研究共纳入 14 项研究。在 VBM 荟萃分析中，共有 481 例患者入组（252 例 KOA 和 229 例健康患者）。在 ALFF 荟萃分析中，共有 518 例患者入组（265 例 KOA 和 253 例健康患者）。荟萃分析结果显示，与健康患者相比，KOA 患者右侧额下回 GM 体积增加，双侧额上回 GM 体积减少，左侧额下回和颞下回脑活动增加，左侧枕中回、右侧缘上回、额上回和顶叶上回脑活动减少。
本荟萃分析中包含的大多数 ALFF 研究均在中国进行。我们的发现仅由 VBM 和 ALFF 研究解决。因此，无法对 KOA 患者的 KOA 持续时间、疼痛强度与异常灰质和脑区功能活动之间的关系进行荟萃回归分析。
本荟萃分析结果表明，KOA 患者 GM 体积和功能活动存在明显异常。这些发现有助于更好地理解 KOA 患者的结构和功能异常。
