The brain in chronic CRPS pain: abnormal gray-white matter interactions in emotional and autonomic regions.
The brain in chronic CRPS pain: abnormal gray-white matter interactions in emotional and autonomic regions.
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DOI：
10.1016/j.neuron.2008.08.022
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发表时间：
2008-11-26
期刊：
影响因子：
16.2
通讯作者：
Apkarian, A. Vania
中科院分区：
文献类型：
--
作者：
Geha, Paul Y.;Baliki, Marwan N.;Harden, R. Norman;Bauer, William R.;Parrish, Todd B.;Apkarian, A. Vania
慢性复杂区域疼痛综合征(CRPS)是一种伴有自主神经异常的衰弱疼痛状态。我们研究了CRPS患者和匹配对照组的灰质形态测量和白质各向异性。患者表现为1)白质各向异性与全脑灰质体积之间的关系中断，2)右侧脑岛、右侧前额叶腹内侧皮质(VMPFC)和右侧伏隔核周围的灰质萎缩，以及3)左侧扣带-穹窿束各向异性分数的减少。这些区域白质连接的重组以分支模式改变为特征，并增加(VMPFC到岛叶)和降低(VMPFC到基底节)。虽然局部萎缩与疼痛强度和持续时间不同，但特定萎缩区域之间的连接强度与焦虑有关。这些异常包括情绪、自主神经和疼痛感知区域，这意味着它们可能在CRPS的全球临床图景中发挥关键作用。
Chronic complex regional pain syndrome (CRPS) is a debilitating pain condition accompanied by autonomic abnormalities. We investigated gray matter morphometry and white matter anisotropy in CRPS patients and matched controls. Patients exhibited 1) a disrupted relationship between white matter anisotropy and whole-brain gray matter volume, 2) gray matter atrophy in a single cluster encompassing right insula, right ventromedial prefrontal cortex (VMPFC), and right nucleus accumbens, and 3) a decrease in fractional anisotropy in the left cingulum-callosal bundle. Reorganization of white matter connectivity in these regions was characterized by branching pattern alterations, and increased (VMPFC to insula) and decreased connectivity (VMPFC to basal ganglion). While regional atrophy differentially related to pain intensity and duration, the strength of connectivity between specific atrophied regions related to anxiety. These abnormalities encompass emotional, autonomic, and pain perception regions, implying that they likely play a critical role in the global clinical picture of CRPS.
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