半球间和皮质体内白质功能障碍是慢性疼痛中影响性发病率和疼痛调节障碍的基础
Atsushi Ito1, Sushuang Yang2, Eri Shinto2
1From the Department of Psychosomatic Dentistry, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan.
Anesthesia and analgesia
|June 5, 2024
概括
慢性疼痛患者表现出影响疼痛调节的白质变化. 扩散张力成像揭示了半球间通信受损,这可能是慢性疼痛发展的新机制.
科学领域:
- 神经成像是一种神经成像.
- 疼痛医学 医学 疼痛医学
- 神经学 神经学
背景情况:
- 患有慢性疼痛的患者显示内源性疼痛调节受损.
- 负责疼痛调节的大脑网络需要解剖学界限.
- 扩散张力成像 (DTI) 可以揭示慢性疼痛中的白质变化.
研究的目的:
- 为了研究使用DTI的慢性疼痛患者的白质变化.
- 使用偏移止痛 (OA) 范式测量热疼痛调节反应.
- 为了将白质指数与疼痛感知和心理物理参数相关联.
- 评估白质量指数作为慢性疼痛诊断生物标志物的潜力.
主要方法:
- 26名慢性疼痛患者和18名健康对照人接受了DTI和OA测量.
- 全脑DTI使用3特斯拉MRI扫描仪进行.
- 使用FSL计算了分数异构性 (FA) 和辐射扩散性 (RD).
- 分析了白质指数,疼痛反应和心理物理参数之间的相关性.
- 使用接收器操作特征分析来区分患者和对照组.
主要成果:
- 患者在OA期间表现出疼痛感知时间动态的改变.
- 在患者的白质中观察到减少的平均FA和增加的平均RD,特别是在体和前丘脑辐射中.
- 在大脑质体的脏中的FA与疼痛延迟度的测量相关.
- 疼痛灾难性得分在特定的白物质区域与FA负相关.
- 白质量指标和OA参数有效地区分了患者和对照组.
结论:
- 慢性疼痛与影响半球间通信和下降疼痛调制的白物质功能障碍有关.
- 疼痛感知和情感发病率的时间动态变化与这些白质变化有关.
- 通过大脑体损害的半球间疼痛调制可能代表了疼痛慢性化的新机制.
相关概念视频
Analgesia and Pain Management
579
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
579
Nociception
27.8K
Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain.
27.8K
Spinal Cord: Cross-sectional Anatomy
1.8K
The cross-sectional anatomy of the spinal cord offers a detailed view of its complex structure and function within the central nervous system. At the core of the spinal cord lies the gray matter, characterized by its butterfly or "H"-shaped appearance in cross-section. This central region is enveloped by white matter, with the overall structure divided into symmetrical halves by the dorsal median sulcus and the ventral median fissure.
Gray Matter and its Components
Central to the gray matter is...
Gray Matter and its Components
Central to the gray matter is...
1.8K
Pain
474
Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...
474


