Lower Functional Connectivity of the Periaqueductal Gray Is Related to Negative Affect and Clinical Manifestations of Fibromyalgia.
Lower Functional Connectivity of the Periaqueductal Gray Is Related to Negative Affect and Clinical Manifestations of Fibromyalgia.
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DOI：
10.3389/fnana.2017.00047
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发表时间：
2017
影响因子：
2.9
通讯作者：
Davis KD
中科院分区：
文献类型：
--
作者：
Coulombe MA;Lawrence KS;Moulin DE;Morley-Forster P;Shokouhi M;Nielson WR;Davis KD
纤维肌痛（FM）综合征的特征是慢性广泛疼痛，肌肉压痛和情绪困扰。先前的研究发现FM的内源性疼痛调制减少。这种疼痛调节的缺陷可能与FM患者经历的慢性疼痛和其他临床症状的属性有关。因此，我们测试是否有FM的临床症状和功能连接（FC）的导水管周围灰质（PAG），疼痛调制的关键节点之间的联系。我们收集了23名女性FM患者和16名年龄和性别匹配的健康对照者（HC）的静息态3 T功能MRI（rsfMRI）数据，并使用简明疼痛量表（BPI）、纤维肌痛影响问卷（FIQ）、医院焦虑和抑郁量表（HADS）和疼痛灾难性量表（PCS）评估FM症状。我们发现FM患者在PAG FC中表现出统计学上显著的中断，特别是涉及负面情绪，自我意识和显着性的大脑区域。具体来说，我们发现，相比HC，FM患者有较强的PAG FC与舌回和海马，但较弱的PAG FC与运动/执行功能，显着性（SN）和默认模式网络（DMN）相关的区域。PAG FC的衰减与FIQ评分呈负相关，与PCS的放大分量表呈正相关。这些改变与FM的情绪和行为症状相关。我们的研究表明，PAG是导致FM临床表现和疼痛的功能障碍部位。
Fibromyalgia (FM) syndrome is characterized by chronic widespread pain, muscle tenderness and emotional distress. Previous studies found reduced endogenous pain modulation in FM. This deficiency of pain modulation may be related to the attributes of chronic pain and other clinical symptoms experienced in patients with FM. Thus, we tested whether there is a link between the clinical symptoms of FM and functional connectivity (FC) of the periaqueductal gray (PAG), a key node of pain modulation. We acquired resting state 3T functional MRI (rsfMRI) data from 23 female patients with FM and 16 age- and sex- matched healthy controls (HC) and assessed FM symptoms with the Brief Pain Inventory (BPI), Fibromyalgia Impact Questionnaire (FIQ), Hospital Anxiety and Depression Scale (HADS) and Pain Catastrophizing Scale (PCS). We found that patients with FM exhibit statistically significant disruptions in PAG FC, particularly with brain regions implicated in negative affect, self-awareness and saliency. Specifically, we found that, compared to HCs, the FM patients had stronger PAG FC with the lingual gyrus and hippocampus but weaker PAG FC with regions associated with motor/executive functions, the salience (SN) and default mode networks (DMN). The attenuated PAG FC was also negatively correlated with FIQ scores, and positively correlated with the magnification subscale of the PCS. These alterations were correlated with emotional and behavioral symptoms of FM. Our study implicates the PAG as a site of dysfunction contributing to the clinical manifestations and pain in FM.