Gao Zhen, Cui Meng-Jie, Wang Hai-Jun, Zhang Jing, Xu Cheng, Ji Lai-Xi
Experimental Management Center, Shanxi University of Traditional Chinese Medicine, Taiyuan, Shanxi, 030024, People's Republic of China.
Second Clinical Medical College, Shanxi University of Traditional Chinese Medicine, Taiyuan, Shanxi, 030024, People's Republic of China.
J Pain Res. 2025 Feb 4;18:579-587. doi: 10.2147/JPR.S500924. eCollection 2025.
The objective of this research is to delve into the central pathological mechanisms involved in the transformation from acute to chronic pain.
This study enrolled 86 individuals with acute neck pain and 89 with chronic neck pain. Utilizing a 3.0T MR scanner, we obtained three-dimensional T1-weighted imaging (3D-T1WI) images and analyzed structural differences between the two groups with Freesurfer software to evaluate alterations in cortical thickness. Additionally, Blood Oxygen Level-Dependent functional Magnetic Resonance Imaging (BOLD-fMRI) images were acquired to assess intergroup differences in low-frequency amplitude using DPARSF software.
Chronic neck pain patients exhibited increased cortical thickness in the left rostral middle frontal, left isthmus cingulate, left superior frontal, and right precuneus regions compared to those with acute neck pain. Low-frequency amplitude measures revealed decreased activity in the left dorsolateral superior frontal gyrus and left postcentral gyrus, among other areas, and increased activity in the right middle frontal gyrus and the opercular part of the right inferior frontal gyrus.
Our findings indicate that dysfunction and structural changes in the limbic system and prefrontal cortex may play a pivotal role in the progression from acute to chronic neck pain. These insights provide a significant new direction for understanding the central mechanisms underlying pain chronicity.
本研究的目的是深入探究急性疼痛向慢性疼痛转变过程中的核心病理机制。
本研究纳入了86例急性颈部疼痛患者和89例慢性颈部疼痛患者。使用3.0T磁共振成像扫描仪，我们获取了三维T1加权成像（3D-T1WI）图像，并使用Freesurfer软件分析两组之间的结构差异，以评估皮质厚度的变化。此外，还采集了血氧水平依赖性功能磁共振成像（BOLD-fMRI）图像，使用DPARSF软件评估低频振幅的组间差异。
与急性颈部疼痛患者相比，慢性颈部疼痛患者在左侧额中回前部、左侧扣带峡部、左侧额上回和右侧楔前叶区域的皮质厚度增加。低频振幅测量显示，除其他区域外，左侧额上回背外侧和左侧中央后回的活动减少，右侧额中回和右侧额下回岛盖部的活动增加。
我们的研究结果表明，边缘系统和前额叶皮质的功能障碍和结构变化可能在急性颈部疼痛向慢性颈部疼痛的转变过程中起关键作用。这些见解为理解疼痛慢性化的中枢机制提供了一个重要的新方向。
