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慢性难治疼痛患者的休息状态大脑功能连接,这些患者对脊髓刺激治疗有反应
Kyohei Ueno1, Yoshitetsu Oshiro1, Shigeyuki Kan2
1Department of Anesthesiology, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
British journal of anaesthesia
|November 30, 2024
概括
休息状态的功能性MRI可以预测脊髓刺激 (SCS) 对于慢性疼痛的成功. 大脑连接模式准确地识别了可能受益于SCS治疗的患者,有助于个性化疼痛管理.
科学领域:
- 神经科学是一个神经科学.
- 医疗成像医学成像
- 疼痛管理 疼痛管理
背景情况:
- 脊髓刺激 (SCS) 是慢性疼痛的常见治疗方法,但个体反应各不相同.
- 需要SCS有效性的预测工具来指导治疗决策.
- 休息状态功能磁共振成像 (fMRI) 被调查为一种潜在的预测工具.
研究的目的:
- 确定静止状态fMRI是否可以预测患者对脊髓刺激 (SCS) 的反应.
- 为了确定与SCS治疗结果相关的特定功能连接模式.
主要方法:
- 在SCS试验之前,29名慢性疼痛患者接受了休息状态fMRI.
- 根据疼痛缓解,参与者被分为响应者和不响应者.
- 通过ROC分析分析了两组之间的功能连接差异和与缓解疼痛的相关性.
主要成果:
- 在响应者和不响应者之间,前额带状皮层和前额/后额带状皮层之间的功能连接有显著差异.
- 这种连接模式与疼痛缓解率有负相关性.
- 该模型实现了高预测准确度 (AUC:0.814,灵敏度:71%,特异性:87%).
结论:
- 中部前带带皮层和前/后带皮层之间的功能连接是预测SCS反应的潜在生物标志物.
- 这种基于fMRI的生物标志物可以帮助在干预之前为难治慢性疼痛患者个性化SCS治疗.
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