Enhancing treatment of osteoarthritis knee pain by boosting expectancy: A functional neuroimaging study.
Enhancing treatment of osteoarthritis knee pain by boosting expectancy: A functional neuroimaging study.
复制标题
DOI：
10.1016/j.nicl.2018.01.021
复制
发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Gollub RL
中科院分区：
文献类型：
--
作者：
Kong J;Wang Z;Leiser J;Minicucci D;Edwards R;Kirsch I;Wasan AD;Lang C;Gerber J;Yu S;Napadow V;Kaptchuk TJ;Gollub RL
期望可以显着调节疼痛和治疗效果。本研究旨在研究提高患者的期望值是否可以增强膝关节骨关节炎（KOA）的治疗及其潜在的大脑机制。74名KOA患者被招募并随机分为三组：加强针灸（通过操作来提高期望值），标准针灸或常规治疗（TAU）。每名患者在听取报告前接受了6次治疗，在听取报告后接受了4次额外治疗。在第一次和第六次治疗期间进行了fMRI扫描。我们发现，与标准针灸组或TAU组相比，在六次和十次治疗后，加强针灸组的膝关节疼痛显着减少。静息状态功能连接（rsFC）分析使用的神经核（NAc）作为种子显示rsFC增加NAc和内侧前额叶皮层（MPFC）/喙前扣带皮层（rACC）和背外侧前额叶皮层在加强组相比，标准针刺组多次治疗后。首次治疗后的期望评分与治疗后NAc-rACC/MPFC rsFC增加和膝关节疼痛减少显著相关。我们的研究为提高KOA患者疼痛的治疗提供了一种新的方法和机制。我们的研究结果可能有助于提高药理学和综合药物在临床环境中的结果。针刺增强预期产生更大的疼痛缓解KOA患者。针刺后NAc - ACC/MPFC rsFC增加，期望值增加。NAc - ACC/MPFC rsFC增加与临床改善相关。我们的发现为促进慢性疼痛的治疗提供了一种新方法。
Expectation can significantly modulate pain and treatment effects. This study aims to investigate if boosting patients' expectancy can enhance the treatment of knee osteoarthritis (KOA), and its underlying brain mechanism. Seventy-four KOA patients were recruited and randomized to three groups: boosted acupuncture (with a manipulation to enhance expectation), standard acupuncture, or treatment as usual (TAU). Each patient underwent six treatments before being debriefed, and four additional treatments after being debriefed. The fMRI scans were applied during the first and sixth treatment sessions. We found significantly decreased knee pain in the boosted acupuncture group compared to the standard acupuncture or TAU groups after both six and ten treatments. Resting state functional connectivity (rsFC) analyses using the nucleus accumbens (NAc) as the seed showed rsFC increases between the NAc and the medial prefrontal cortex (MPFC)/rostral anterior cingulate cortex (rACC) and dorsolateral prefrontal cortex in the boosted group as compared to the standard acupuncture group after multiple treatments. Expectancy scores after the first treatment were significantly associated with increased NAc-rACC/MPFC rsFC and decreased knee pain following treatment. Our study provides a novel method and mechanism for boosting the treatment of pain in patients with KOA. Our findings may shed light on enhancing outcomes of pharmacological and integrative medicines in clinical settings. Acupuncture with enhanced expectancy produced greater pain relief in KOA patients. NAc – ACC/MPFC rsFC increased after acupuncture with enhanced expectancy. NAc – ACC/MPFC rsFC increases are associated with clinical improvements. Our findings provide a novel method for boosting the treatment of chronic pain.
登录
查看更多内容
影响因子：
--
作者：
Cherkin, Daniel C.;Sherman, Karen J.;Avins, Andrew L.;Erro, Janet H.;Ichikawa, Laura;Barlow, William E.;Delaney, Kristin;Hawkes, Rene;Hamilton, Luisa;Pressman, Alice;Khalsa, Partap S.;Deyo, Richard A.
通讯作者：
Deyo, Richard A.
影响因子：
7.4
作者：
Egorova N;Yu R;Kaur N;Vangel M;Gollub RL;Dougherty DD;Kong J;Camprodon JA
通讯作者：
Camprodon JA
影响因子：
3.3
作者：
Chen X;Spaeth RB;Freeman SG;Scarborough DM;Hashmi JA;Wey HY;Egorova N;Vangel M;Mao J;Wasan AD;Edwards RR;Gollub RL;Kong J
通讯作者：
Kong J
影响因子：
7.4
作者：
GRACELY, RH;MCGRATH, P;DUBNER, R
通讯作者：
DUBNER, R
影响因子：
17.1
作者：
Gollub, Randy L.;Kong, Jian
通讯作者：
Kong, Jian