Comparison of brain structure between pain-susceptible and asymptomatic individuals following experimental induction of low back pain
Comparison of brain structure between pain-susceptible and asymptomatic individuals following experimental induction of low back pain
复制标题
DOI：
10.1016/j.spinee.2019.08.015
复制
发表时间：
2020-02-01
期刊：
影响因子：
4.5
通讯作者：
Bishop, Mark D.
中科院分区：
文献类型：
--
作者：
Boissoneault, Jeff;Penza, Charles W.;Bishop, Mark D.
背景：外周差异通常不能充分解释肌肉骨骼疼痛患者疼痛强度报告的差异。目的：在这里，我们试图确定无痛个体的大脑结构差异（灰质密度）在多大程度上可能与标准化外周肌肉损伤（即高强度运动引起的微创伤）后的后续疼痛（或缺乏疼痛）有关。研究设计：这是一项基于实验室的观察性研究，是一项大型试验的二次分析。方法：参与者完成基线测试（功能性MRI和定量疼痛测试），然后进行高强度躯干运动，以诱导竖脊肌的延迟性肌肉酸痛。48小时后，收集背部疼痛强度评分，并对所有参与者进行重新成像。采用基于体素的形态测量法测定灰质密度。将“无症状”组（诱导后48小时内无任何疼痛报告）分为“疼痛”组（静止和运动时疼痛评分为bbb20，满分为101分）。结果：我们的结果揭示了几个大的集群，与有疼痛的参与者相比，无症状的参与者有更大的灰质密度。这些脑区包括左侧额内侧回、左侧枕中回、左侧颞中回、左侧额下回和右侧额上回。结论：先前与皮层处理的辨别、情感和认知方面相关的脑区域灰质密度降低与标准化外周肌肉损伤后报告的肌肉骨骼疼痛有关。临床意义：没有任何疼痛的人的皮质灰质密度可能影响对标准化高强度运动方案的反应。这一发现进一步支持了解释急性肌肉骨骼损伤后疼痛报告的巨大个体差异的中心因素的相关性。(C) 2019 Elsevier Inc.版权所有。
BACKGROUND CONTEXT: Peripheral differences often do not adequately account for variation in reports of pain intensity in people with musculoskeletal pain.PURPOSE: Here we sought to determine the extent to which structural differences in the brain (grey matter density) of pain free individuals might relate to subsequent pain (or lack thereof) after standardized peripheral muscle injury (ie, micro trauma from high intensity exercise).STUDY DESIGN: This was an observational laboratory-based study that was a secondary analysis from a larger trial.METHODS: Participants completed baseline testing (functional MRI and quantitative pain testing) followed by high intensity trunk exercise to induce delayed onset muscle soreness in the erector spinae. Forty-eight hours later, back pain intensity ratings were collected and all participants were re-imaged. Grey matter density was determined using voxel-based morphometry. The "asymptomatic" group (no reports of any pain within 48 hours after induction) to a 'pain' group (rating of pain at rest and movement pf>20 on a 101-point numeric rating scale).RESULTS: Our results revealed several large clusters where, compared to participants with pain, asymptomatic participants had significant greater grey matter density. These brain regions included left medial frontal gyrus, left middle occipital gyrus, left middle temporal gyrus, left inferior frontal gyrus, and right superior frontal gyrus.CONCLUSIONS: Lower grey matter density in brain regions previously linked to discriminative, emotional, and cognitive aspects of cortical processing are associated with reporting musculoskeletal pain after a standardized peripheral muscle injury.CLINICAL SIGNIFICANCE: Cortical gray matter density of people without any pain may influence response to a standardized high intensity exercise protocol. This finding adds further support to the relevance of central factors in explaining the tremendous individual variability in pain report following acute musculoskeletal injury. (C) 2019 Elsevier Inc. All rights reserved.