大脑网络连接和疼痛敏感性的生物标记物区分低应对能力和高应对能力的退伍军人与持续的创伤后头痛
Katrina S Monroe1, Dawn M Schiehser2,3, Aaron W Parr4
1School of Physical Therapy, College of Health and Human Services, San Diego State University, San Diego, California, USA.
Journal of neurotrauma
|August 8, 2025
概括
持续的创伤后头痛 (PPTH) 与部疼痛可能涉及不同的生物模式. 较大的大脑连接和疼痛敏感性问题,而不是部肌肉问题,定义了较差的疼痛应对和较高残疾的子组.
科学领域:
- 神经科学是一个神经科学.
- 疼痛医学 医学 疼痛医学
- 创伤研究 创伤研究
背景情况:
- 头痛是轻度创伤性脑损伤 (TBI) 的常见后果.
- 持续的创伤后头痛 (PPTH) 通常与部疼痛同时发生,加剧头痛的严重程度和功能影响.
- 识别生物学表型对于部疼痛的PPTH有针对性的管理至关重要.
研究的目的:
- 为了识别带有PPTH和同时出现的部疼痛的退伍军人中的生物学表型.
- 探索PPTH中大脑功能连接,椎脊柱特征和疼痛敏感性之间的关系.
- 根据生物特征区分子组,以告知基于机制的治疗方法.
主要方法:
- 观察性队列研究涉及33名有PPTH的退伍军人.
- 使用随机森林分析和围绕Medoids集群划分的多维表型.
- 评估包括临床评估,定量感官测试,以及大脑和椎脊柱的MRI,重点关注水管灰色 (PAG) 静止状态功能连接 (rsFC).
主要成果:
- 基于额头压力疼痛值和PAG rsFC与默认模式,突出性和感觉运动网络,出现了两个不同的子组.
- 低疼痛应对子组表现出更高的与疼痛相关的焦虑,灾难化和残疾,以及更低的疼痛自我有效性.
- 面疼痛敏感性和PAG网络连接性,而不是宫肌肉特征,使子组区分开来.
结论:
- 较大的PAG功能连接性和受损的面疼痛敏感性是PPTH患者的一个亚组的特征,这些患者的疼痛应对能力较差,残疾程度较高.
- 宫肌肉健康似乎不是这个队列的区分因素.
- 研究结果强调了神经生物学因素在PPTH管理中的重要性,并提出了潜在的干预目标.
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