Resting-state brain functional connectivity in patients with chronic pain who responded to subanesthetic-dose ketamine.
Resting-state brain functional connectivity in patients with chronic pain who responded to subanesthetic-dose ketamine.
复制标题
对亚麻醉剂量氯胺酮有反应的慢性疼痛患者的静息态大脑功能连接。
DOI：
10.1038/s41598-019-49360-1
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发表时间：
2019
影响因子：
4.6
通讯作者：
Yasushi Motoyama
中科院分区：
文献类型：
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作者：
中島大輔;芳川豊史;伊達洋至;Yasushi Motoyama
氯胺酮已被用于治疗慢性疼痛；然而，目前尚不清楚氯胺酮对哪些类型的慢性疼痛有效。为了确定亚麻醉剂量氯胺酮对慢性疼痛患者的影响并阐明其作用机制，我们使用静息态功能磁共振成像（rs-fMRI）回顾性研究了大脑功能连接。患者被分为有反应者（R 组：数值评定量表改善≥50%）和无反应者（NR 组）。我们通过种子到体素相关分析来比较大脑功能连接方面的差异。两个样本测试显示，R 组内侧前额叶皮层 (mPFC) 和楔前叶之间的连接性显着降低。我们还发现，mPFC 和楔前叶之间的改善率和功能连接强度之间存在显着的负相关。这些发现表明，亚麻醉剂量的氯胺酮对 mPFC 和楔前叶之间的大脑功能连接较低的慢性疼痛患者有效。我们认为，当前的研究首次探讨了大脑功能连接与亚麻醉剂量氯胺酮对慢性疼痛的影响之间的相关性，并表明了在慢性疼痛的药物治疗中使用预测标记的可能性。
Ketamine has been used to treat chronic pain; however, it is still unknown as to what types of chronic pain is ketamine effective against. To identify the effect of administration of subanesthetic-dose ketamine in patients with chronic pain and to clarify the mechanism of the effect, we retrospectively investigated brain functional connectivity using resting-state functional magnetic resonance imaging (rs-fMRI). Patients were divided into responders (Group R: ≥50% improvement on Numerical Rating Scale) and non-responders (Group NR). We compared the differences in terms of brain functional connectivity by seed-to-voxel correlation analysis. Two-samplet-test revealed significant lower connectivity between the medial prefrontal cortex (mPFC) and precuneus in Group R. We also found a significant negative correlation between the improvement rate and functional connectivity strength between the mPFC and precuneus. These findings suggest that subanesthetic-dose ketamine is effective in patients with chronic pain whose brain functional connectivity between the mPFC and precuneus is low. We believe that the current study explored for the first time the correlation between brain functional connectivity and the effect of subanesthetic-dose ketamine for chronic pain and indicated the possibility of use of the predictive marker in pharmacological treatment of chronic pain.