Characteristic cerebral structural changes identified using voxel-based morphometry in patients with post-surgical chronic myelopathic pain
Characteristic cerebral structural changes identified using voxel-based morphometry in patients with post-surgical chronic myelopathic pain
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DOI：
10.1038/s41393-019-0391-0
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发表时间：
2020-04-01
期刊：
影响因子：
2.2
通讯作者：
Nakamura, Masaya
中科院分区：
文献类型：
--
作者：
Horiuchi, Yosuke;Tsuji, Osahiko;Nakamura, Masaya
研究设计横断面研究。目的脊柱髓内手术患者偶尔会出现术后慢性疼痛，但其机制尚未完全清楚。因此，本研究旨在使用基于体素的形态计量学来确定手术后慢性脊髓病疼痛患者的脑结构变化。日本东京的一所大学医院。方法选取2002年1月至2014年4月间行脊髓髓内手术的49例患者作为研究对象。根据术后慢性疼痛强度，将参与者分为两组：对照组（数字评定量表评分= 3）。比较两组患者的疼痛问卷和脑MRI。使用基于体素的形态测量法分析每个参与者的脑MRI数据。结果疼痛组左侧辅助运动区、左侧主运动区和左侧后扣带回灰质体积均高于对照组。此外，数字评定量表评分与左侧主要运动区、左侧后扣带回皮质和右侧上级顶叶小叶的灰质体积增加显著相关。结论本研究采用基于体素的形态计量学方法阐明了脊髓髓内手术后大脑结构的特征性变化，并提示特定脑区的结构变化与术后慢性脊髓病疼痛相关。
Study Design Cross-sectional study. Objective Patients who undergo intramedullary spinal surgery occasionally experience post-surgical chronic pain; however, the underlying mechanisms are not yet completely understood. Therefore, this study aimed to identify the cerebral structural changes in patients with post-surgical chronic myelopathic pain using voxel-based morphometry. Setting Single university hospital in Tokyo, Japan. Methods Forty-nine patients who had undergone intramedullary spinal surgery between January 2002 and April 2014 participated in this study. Participants were classified into two groups based on their post-surgical chronic pain intensity: control (numeric rating scale score of = 3) groups. We compared pain questionnaire and brain MRI between two groups. Brain MRI data of each participants was analyzed using voxel-based morphometry. Results Voxel-based morphometry revealed that the gray matter volume in the left supplementary motor area, left primary motor area, and left posterior cingulate cortex was higher in the pain group than that in the control group. In addition, the numeric rating scale score was significantly correlated with increased gray matter volume in the left primary motor area, left posterior cingulate cortex, and right superior parietal lobule. Conclusion Present study elucidates the characteristic cerebral structural changes after an intramedullary spinal surgery using voxel-based morphometry and indicates that the structural changes in specific cerebral areas are associated with post-surgical chronic myelopathic pain.