Severities in persistent mild traumatic brain injury related headache is associated with changes in supraspinal pain modulatory functions.
Severities in persistent mild traumatic brain injury related headache is associated with changes in supraspinal pain modulatory functions.
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DOI：
10.1177/17448069211037881
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发表时间：
2021-01
期刊：
影响因子：
3.3
通讯作者：
Lee R
中科院分区：
文献类型：
--
作者：
Flowers M;Leung A;Schiehser DM;Metzger-Smith V;Delano-Wood L;Sorg S;Kunnel A;Wong A;Vaninetti M;Golshan S;Lee R
新出现的证据表明轻度创伤性脑损伤相关性头痛（MTBI-HA）是一种神经病理性疼痛状态。先前的脊髓上机制研究表明，与健康对照组相比，MTBI-HA患者表现出分离状态，脊髓上前额叶疼痛调节功能水平降低，脊髓上对疼痛的感觉反应增强。然而，脊髓上疼痛调节功能缺陷和MTBI-HA严重程度之间的关系在很大程度上是未知的。了解这种关系可能会提高对MTBI-HA的了解水平，并促进治疗的发展。本研究通过功能性磁共振成像（fMRI）评估了具有各种头痛强度表型的MTBI-HA患者与对照组相比的疼痛相关脊髓上静息状态。静息状态的fMRI数据进行了分析与自组织组独立成分分析，在三个MTBI-HA强度组（轻度，中度和重度）和一个对照组（n = 16每组）在一个预先定义的脊髓上疼痛网络的基础上先前的研究。在轻度头痛组中，与对照组相比，在右侧运动前区皮质（T = 3.53，p < 0.001）和左侧运动前区皮质（T = 3.99，p < 0.0001）中观察到脊髓上功能的显著增加。在中度头痛组中，与轻度头痛组相比，左侧上级顶叶皮层的静息状态活动显著减少（T =-3.05，p < 0.01）。在严重头痛组，右室静息状态下的棘上活动显著减少，（T =-3.46，p < 0.001），右侧运动前区皮质（T =-3.30，p < 0.01），左侧运动前区皮质（T =-3.84，p < 0.001），左侧顶叶皮质（T =-3.94，p < 0.0001），并且与中度头痛组相比，右侧次级躯体感觉皮层的活动增加（T = 4.05，p < 0.0001）。研究结果表明，MTBI-HA严重程度的增加可能与脊髓上疼痛网络的不平衡有关，脊髓上疼痛调节功能下降，感觉/疼痛解码增强。
Emerging evidence suggests mild traumatic brain injury related headache (MTBI-HA) is a form of neuropathic pain state. Previous supraspinal mechanistic studies indicate patients with MTBI-HA demonstrate a dissociative state with diminished levels of supraspinal prefrontal pain modulatory functions and enhanced supraspinal sensory response to pain in comparison to healthy controls. However, the relationship between supraspinal pain modulatory functional deficit and severity of MTBI-HA is largely unknown. Understanding this relationship may provide enhanced levels of insight about MTBI-HA and facilitate the development of treatments. This study assessed pain related supraspinal resting states among MTBI-HA patients with various headache intensity phenotypes with comparisons to controls via functional magnetic resonance imaging (fMRI). Resting state fMRI data was analyzed with self-organizing-group-independent-component-analysis in three MTBI-HA intensity groups (mild, moderate, and severe) and one control group (n = 16 per group) within a pre-defined supraspinal pain network based on prior studies. In the mild-headache group, significant increases in supraspinal function were observed in the right premotor cortex (T = 3.53, p < 0.001) and the left premotor cortex (T = 3.99, p < 0.0001) when compared to the control group. In the moderate-headache group, a significant (T = −3.05, p < 0.01) decrease in resting state activity was observed in the left superior parietal cortex when compared to the mild-headache group. In the severe-headache group, significant decreases in resting state supraspinal activities in the right insula (T = −3.46, p < 0.001), right premotor cortex (T = −3.30, p < 0.01), left premotor cortex (T = −3.84, p < 0.001), and left parietal cortex (T = −3.94, p < 0.0001), and an increase in activity in the right secondary somatosensory cortex (T = 4.05, p < 0.0001) were observed when compared to the moderate-headache group. The results of the study suggest that the increase in MTBI-HA severity may be associated with an imbalance in the supraspinal pain network with decline in supraspinal pain modulatory function and enhancement of sensory/pain decoding.
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影响因子：
2
作者：
Defrin, Ruth
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影响因子：
7.8
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DOI：
10.1016/j.apmr.2008.11.005
发表时间：
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影响因子：
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影响因子：
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