Liu Dong, Lin Churong, Liu Budian, Zhang Yanli, Jiang Yutong, Gu Jieruo, Jin Ou
Department of Rheumatology, the Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, China.
Department of Radiology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
BMC Musculoskelet Disord. 2025 Jan 23;26(1):80. doi: 10.1186/s12891-025-08322-7.
Lower back pain comprises the majority of the disease burden of patients with ankylosing spondylitis (AS), while the alterations of the large-scale brain networks could be implicated in the neuropathophysiology of pain. The frontoparietal network (FPN) is known as a pain modulation hub, with key nodes dorsolateral prefrontal cortex (dlPFC) and ventrolateral prefrontal cortex (vlPFC) participating in the pain modulation and reappraisal process. In this study, we adopted the analytical approaches of independent component analysis (ICA) and seed-based correlation analysis (SCA) to examine the resting-state functional connectivity (rsFC) of the large-scale brain networks, notably FPN, between 82 AS patients and 61 healthy controls (HCs). We also investigated the correlation between the rsFC and the clinical measures of AS patients. Both ICA and SCA consistently showed that the rsFC between FPN and mPFC, a key node of the default mode network (DMN), was significantly increased in AS. In addition, SCA also identified a cluster at the right posterior lobe of cerebellum which exhibited increased rsFC with the posterior cingulate cortex, and the right lateral prefrontal cortex also showed increased rsFC with the right dlPFC. Correlation analysis showed that the rsFC between mPFC and the left anterior prefrontal cortex was significantly correlated with C-reactive protein in AS. The increased FPN-DMN connectivity could contribute to the neuropathophysiology of lower back pain in AS, with potential association with faulty pain modulation and reappraisal mechanisms facilitated by the FPN.
下背痛构成了强直性脊柱炎（AS）患者疾病负担的大部分，而大规模脑网络的改变可能与疼痛的神经病理生理学有关。额顶叶网络（FPN）被认为是一个疼痛调节中枢，关键节点背外侧前额叶皮质（dlPFC）和腹外侧前额叶皮质（vlPFC）参与疼痛调节和重新评估过程。在本研究中，我们采用独立成分分析（ICA）和基于种子点的相关分析（SCA）方法，研究了82例AS患者和61名健康对照（HCs）之间大规模脑网络（尤其是FPN）的静息态功能连接（rsFC）。我们还研究了rsFC与AS患者临床指标之间的相关性。ICA和SCA均一致显示，AS患者中FPN与默认模式网络（DMN）的关键节点内侧前额叶皮质（mPFC）之间的rsFC显著增加。此外，SCA还在小脑右后叶发现了一个簇，其与后扣带回皮质的rsFC增加，右侧前额叶外侧皮质与右侧dlPFC的rsFC也增加。相关性分析表明，AS患者中mPFC与左侧前额叶前皮质之间的rsFC与C反应蛋白显著相关。FPN-DMN连接性增加可能导致AS患者下背痛的神经病理生理学改变，可能与FPN促进的疼痛调节和重新评估机制异常有关。
