Qiu Zhiqiang, Liu Tianci, Zeng Chengxi, Yang Maojiang, Xu Xiaoxue
Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Department of Pain, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Front Neurosci. 2025 Jan 6;18:1485045. doi: 10.3389/fnins.2024.1485045. eCollection 2024.
To investigate differences in the microstructure of the spinothalamic tract (STT) white matter in people with chronic neck and shoulder pain (CNSP) using diffusion tensor imaging, and to assess its correlation with pain intensity and duration of the pain.
A 3.0T MRI scanner was used to perform diffusion tensor imaging scans on 31 people with CNSP and 24 healthy controls (HCs), employing the Automatic Fiber Segmentation and Quantification (AFQ) method to extract the STT and quantitatively analyze the fractional anisotropy (FA) and mean diffusivity (MD), reflecting the microstructural integrity of nerve fibers. Correlations of these differences with duration of pain and visual analog scale (VAS) scores were analyzed.
No significant differences in the mean FA or MD values of the bilateral STT were observed between people with CNSP and HCs ( > 0.05), as indicated by the two-sample t test. Further point-by-point comparison along 100 equidistant nodes within the STT pathway revealed significant reductions in FA values in the left (segments 12-18, 81-89) and right (segments 9-19, 76-80) STT in the CNSP group compared to HCs; significant increases in MD values were observed in the left (segments 1-13, 26-30, 71-91) and right (segments 8-17, 76-91) STT ( < 0.05, FWE corrected). Partial correlation analysis indicates that in people with CNSP, the FA values of the STT in regions with damaged white matter structure show a negative correlation with VAS scores and duration of pain, whereas MD values show a positive correlation with VAS scores and duration of pain.
This study found that people with CNSP exhibit white matter microstructural abnormalities in the specific segments of STT. These abnormalities are associated with the patient's pain intensity and disease duration. The findings offer a new neuroimaging perspective on the pathophysiological basis of chronic pain in the ascending conduction process and its potential role in developing targeted intervention strategies. However, due to the limited sample size and the lack of statistical significance when analyzing the entire spinothalamic tract, these conclusions should be interpreted with caution. Further research with larger cohorts is necessary to validate these results.
利用扩散张量成像研究慢性颈肩痛（CNSP）患者脊髓丘脑束（STT）白质的微观结构差异，并评估其与疼痛强度和疼痛持续时间的相关性。
使用3.0T MRI扫描仪对31例CNSP患者和24例健康对照者（HCs）进行扩散张量成像扫描，采用自动纤维分割和量化（AFQ）方法提取STT并定量分析反映神经纤维微观结构完整性的分数各向异性（FA）和平均扩散率（MD）。分析这些差异与疼痛持续时间和视觉模拟量表（VAS）评分的相关性。
两样本t检验结果显示，CNSP患者与HCs双侧STT的平均FA值或MD值无显著差异（>0.05）。沿STT通路内100个等距节点进行进一步逐点比较发现，与HCs相比，CNSP组左侧（节段12 - 18、81 - 89）和右侧（节段9 - 19、76 - 80）STT的FA值显著降低；左侧（节段1 - 13、26 - 30、71 - 91）和右侧（节段8 - 17、76 - 91）STT的MD值显著升高（<0.05，FWE校正）。偏相关分析表明，在CNSP患者中，白质结构受损区域的STT的FA值与VAS评分和疼痛持续时间呈负相关，而MD值与VAS评分和疼痛持续时间呈正相关。
本研究发现CNSP患者在STT的特定节段存在白质微观结构异常。这些异常与患者的疼痛强度和病程相关。这些发现为慢性疼痛在上升传导过程中的病理生理基础及其在制定靶向干预策略中的潜在作用提供了新的神经影像学视角。然而，由于样本量有限且分析整个脊髓丘脑束时缺乏统计学意义，这些结论应谨慎解释。需要更大样本量的进一步研究来验证这些结果。
