Understanding Pain and Trauma Symptoms in Veterans From Resting-State Connectivity: Unsupervised Modeling.
Understanding Pain and Trauma Symptoms in Veterans From Resting-State Connectivity: Unsupervised Modeling.
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DOI：
10.3389/fpain.2022.871961
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发表时间：
2022
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影响因子：
--
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创伤和创伤后应激与慢性疼痛高度共病，并且通常是发展慢性疼痛状况的前因。疼痛和创伤与更多地利用医疗服务、更多地使用精神病药物和增加治疗总费用有关。尽管在临床上高度重叠，疼痛和创伤的神经机制往往被分开研究。在这项研究中，静息态功能磁共振成像（rs-fMRI）扫描完成了一系列背痛和创伤症状的退伍军人诊断异质性样本。使用组迭代多模型估计（GIMME），一种有效的功能连接分析，我们探索了一种无监督模型，该模型基于先验定义的感兴趣区域（ROI）中涉及疼痛和创伤的大脑区域的路径相似性导出子组。三个亚组被确定的功能连接的模式和不同的几个心理措施，尽管相似的人口和诊断特征。第一个亚组总体上高度连接，其特征在于从延髓核（NAc）、前扣带皮层（ACC）和后扣带皮层（PCC）到延髓的功能连接，并且疼痛和创伤症状评分较低。第二个亚组与第一个亚组在疼痛和创伤测量方面没有显著差异，但其特征在于从ACC和NAc到丘脑以及从ACC到PCC的功能连接。第三个亚组的特征是从丘脑和PCC到NAc的功能连接，并且在疼痛和创伤症状上得分很高。我们的研究结果表明，尽管人口统计学和诊断的相似性，可能有神经生物学分离的生物型与不同的机制来管理疼痛和创伤。这些发现可能对确定针对这些神经系统的适当生物型特异性干预措施具有影响。
Trauma and posttraumatic stress are highly comorbid with chronic pain and are often antecedents to developing chronic pain conditions. Pain and trauma are associated with greater utilization of medical services, greater use of psychiatric medication, and increased total cost of treatment. Despite the high overlap in the clinic, the neural mechanisms of pain and trauma are often studied separately. In this study, resting-state functional magnetic resonance imaging (rs-fMRI) scans were completed among a diagnostically heterogeneous sample of veterans with a range of back pain and trauma symptoms. Using Group Iterative Multiple Model Estimation (GIMME), an effective functional connectivity analysis, we explored an unsupervised model deriving subgroups based on path similarity in a priori defined regions of interest (ROIs) from brain regions implicated in the experience of pain and trauma. Three subgroups were identified by patterns in functional connection and differed significantly on several psychological measures despite similar demographic and diagnostic characteristics. The first subgroup was highly connected overall, was characterized by functional connectivity from the nucleus accumbens (NAc), the anterior cingulate cortex (ACC), and the posterior cingulate cortex (PCC) to the insula and scored low on pain and trauma symptoms. The second subgroup did not significantly differ from the first subgroup on pain and trauma measures but was characterized by functional connectivity from the ACC and NAc to the thalamus and from ACC to PCC. The third subgroup was characterized by functional connectivity from the thalamus and PCC to NAc and scored high on pain and trauma symptoms. Our results suggest that, despite demographic and diagnostic similarities, there may be neurobiologically dissociable biotypes with different mechanisms for managing pain and trauma. These findings may have implications for the determination of appropriate biotype-specific interventions that target these neurological systems.
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影响因子：
3.7
作者：
Baliki MN;Mansour AR;Baria AT;Apkarian AV
通讯作者：
Apkarian AV
影响因子：
16.2
作者：
Baliki, Marwan N.;Geha, Paul Y.;Fields, Howard L.;Apkarian, A. Vania
通讯作者：
Apkarian, A. Vania
影响因子：
82.9
作者：
Drysdale AT;Grosenick L;Downar J;Dunlop K;Mansouri F;Meng Y;Fetcho RN;Zebley B;Oathes DJ;Etkin A;Schatzberg AF;Sudheimer K;Keller J;Mayberg HS;Gunning FM;Alexopoulos GS;Fox MD;Pascual-Leone A;Voss HU;Casey BJ;Dubin MJ;Liston C
通讯作者：
Liston C
DOI：
10.1523/jneurosci.1984-11.2011
发表时间：
2011-09-28
期刊：
The Journal of neuroscience : the official journal of the Society for Neuroscience
影响因子：
--
作者：
Baliki MN;Baria AT;Apkarian AV
通讯作者：
Apkarian AV
影响因子：
5.3
作者：
Baliki, Marwan N.;Chialvo, Dante R.;Apkarian, A. Vania
通讯作者：
Apkarian, A. Vania