通过置换和网络分析实现关节炎疼痛的精准连接性：迈向临床应用的关键一步。
Precision Connectivity in Arthritis Pain with Permutation and Network Analysis: A Key Step Toward Clinical Application.
作者信息
Robinson Belfin, Cediel Emilio G, Reuther William, Kodali Aryan, Srabani Ellora, Leggio Olivia, Krishna Vibhor, Boerwinkle Varina L
机构信息
University of North Carolina at Chapel Hill.
出版信息
Res Sq. 2025 Sep 3:rs.3.rs-6915471. doi: 10.21203/rs.3.rs-6915471/v1.
OBJECTIVE
This study seeks to identify brain regions with atypical neural connectivity in individuals suffering from arthritis-related chronic pain, compared to healthy controls, using resting-state functional magnetic resonance imaging (rs-fMRI).
METHODS
A seed-based connectivity analysis was conducted between the known pain-related regions of interest (ROIs), derived from the MNI (n = 76) and the Automated Anatomical Labeling (AAL) whole brain atlas (n = 116). We examined the connectivity differences in a cohort of 56 osteoarthritis patients and 20 healthy controls. Connectivity matrices were compared using permutation tests corrected for multiple comparisons, identifying statistically significant differences (p < 0.05). Subsequent network analysis resulted in hub scores, identifying the most central and influential brain regions within the altered connectivity network in patients experiencing pain.
RESULTS
The most significant atypical neural connections in osteoarthritis patients were identified in the cingulate gyrus, insula, inferior parietal lobe, and thalamus, with notable involvement of the occipital lobe, postcentral gyrus, inferior frontal gyrus, orbitofrontal cortex, temporal lobe, hippocampus, and basal ganglia. The thalamus, cingulate gyrus, and insula emerged as key hubs in the chronic pain network, reflecting disrupted sensory, emotional, and cognitive pain processing. No significant connectivity differences were found in the brainstem, cerebellum, superior parietal lobe, precentral gyrus, superior and middle frontal gyri, or amygdala.
CONCLUSION
Our data-driven approach reveals specific neural connectivity disruptions in OA, highlighting connections between the cingulate gyrus, temporal lobe, and thalamus. These findings identify specific network disruptions in OA-related pain, offering insight into altered brain connectivity and potential avenues for targeted interventions.
目的
本研究旨在通过静息态功能磁共振成像（rs-fMRI），与健康对照组相比，识别患有关节炎相关慢性疼痛个体中具有非典型神经连接的脑区。
方法
在源自蒙特利尔神经病学研究所（MNI，n = 76）和自动解剖标记（AAL）全脑图谱（n = 116）的已知疼痛相关感兴趣区域（ROI）之间进行基于种子的连接性分析。我们检查了56名骨关节炎患者和20名健康对照者队列中的连接性差异。使用经多重比较校正的置换检验比较连接性矩阵，确定具有统计学意义的差异（p < 0.05）。随后的网络分析得出枢纽分数，确定疼痛患者中连接性改变网络内最核心和最具影响力的脑区。
结果
在骨关节炎患者中，最显著的非典型神经连接在扣带回、岛叶、顶下小叶和丘脑被识别出来，枕叶、中央后回、额下回、眶额皮质、颞叶、海马体和基底神经节也有明显累及。丘脑、扣带回和岛叶成为慢性疼痛网络中的关键枢纽，反映了感觉、情感和认知性疼痛处理的中断。在脑干、小脑、顶上小叶、中央前回、额上回和额中回或杏仁核中未发现显著的连接性差异。
结论
我们的数据驱动方法揭示了骨关节炎中特定的神经连接中断，突出了扣带回、颞叶和丘脑之间的连接。这些发现确定了骨关节炎相关疼痛中特定的网络中断，为了解大脑连接性改变和靶向干预的潜在途径提供了见解。
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