Working memory performance is correlated with local brain morphology in the medial frontal and anterior cingulate cortex in fibromyalgia patients: structural correlates of paincognition interaction
Working memory performance is correlated with local brain morphology in the medial frontal and anterior cingulate cortex in fibromyalgia patients: structural correlates of paincognition interaction
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DOI：
10.1093/brain/awn229
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发表时间：
2008-12-01
期刊：
影响因子：
14.5
通讯作者：
Schmidt-Wilcke, T.
中科院分区：
文献类型：
--
作者：
Luerding, R.;Weigand, T.;Schmidt-Wilcke, T.
纤维肌痛（FM）是一种病因不明的疾病，以慢性广泛性疼痛、僵硬和睡眠障碍为特征。此外，患者经常抱怨记忆力和注意力缺陷。越来越多的证据表明，FM与中枢神经系统功能障碍和大脑形态改变有关。然而，很少有研究专门研究FM患者的神经心理问题。因此，我们试图确定在FM患者中发现的神经心理缺陷是否可能与局部大脑形态学的变化有关，特别是在额叶、颞叶或扣带皮层。20例FM患者接受了广泛的潜在神经心理缺陷测试，与年龄和教育程度匹配的对照组相比，这些患者的工作记忆明显减少，非语言长期记忆受损（仅限于自由回忆条件）。使用基于体素的形态测量（VBM）来评估测试结果与局部脑形态之间的潜在相关性。非语言工作记忆的表现与左背外侧前额叶皮层灰质值呈正相关，而语言工作记忆（手指后向）的表现与辅助运动皮层灰质值呈正相关。另一方面，疼痛评分与内侧额回灰质值呈负相关。白质分析显示，言语工作记忆和疼痛评分在内侧额叶皮层、前额叶皮层和前扣带皮层具有可比的相关性。我们的数据表明，除了慢性疼痛外，FM患者还存在与额叶和前扣带回局部脑形态相关的神经认知缺陷，这可能被解释为疼痛认知相互作用的结构相关。
Fibromyalgia (FM) is a disorder of unknown aetiology, characterized by chronic widespread pain, stiffness and sleep disturbances. In addition, patients frequently complain of memory and attention deficits. Accumulating evidence suggests that FM is associated with CNS dysfunction and with an altered brain morphology. However, few studies have specifically investigated neuropsychological issues in patients suffering from FM. We therefore sought to determine whether neuropsychological deficits found in FM patients may be correlated with changes in local brain morphology specifically in the frontal, temporal or cingulate cortices. Twenty FM patients underwent extensive testing for potential neuropsychological deficits, which demonstrated significantly reduced working memory and impaired non-verbal long-term memory (limited to free recall condition) in comparison with normative data from age- and education-matched control groups. Voxel-based morphometry (VBM) was used to evaluate for potential correlations between test results and local brain morphology. Performance on non-verbal working memory was positively correlated with grey matter values in the left dorsolateral prefrontal cortex, whereas performance on verbal working memory (digit backward) was positively correlated with grey matter values in the supplementary motor cortex. On the other hand, pain scores were negatively correlated with grey matter values in the medial frontal gyrus. White matter analyses revealed comparable correlations for verbal working memory and pain scores in the medial frontal and prefrontal cortex and in the anterior cingulate cortex. Our data suggest that, in addition to chronic pain, FM patients suffer from neurocognitive deficits that correlate with local brain morphology in the frontal lobe and anterior cingulate gyrus, which may be interpreted to indicate structural correlates of paincognition interaction.