Colocalized structural and functional changes in the cortex of patients with trigeminal neuropathic pain.
Colocalized structural and functional changes in the cortex of patients with trigeminal neuropathic pain.
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DOI：
10.1371/journal.pone.0003396
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发表时间：
2008
期刊：
影响因子：
3.7
通讯作者：
Borsook D
中科院分区：
文献类型：
--
作者：
DaSilva AF;Becerra L;Pendse G;Chizh B;Tully S;Borsook D
最近的数据表明，在慢性疼痛中，灰质的变化与脑体积的减少一致，表明疾病过程可能会在受影响的大脑中产生形态学变化。然而，没有研究评估皮层厚度与诱发疼痛的特定功能变化的关系。在这项研究中，我们试图调查结构（灰质厚度）和功能（血氧依赖性水平- BOLD）的变化，在精确匹配的患者的皮质区域的慢性三叉神经痛（TNP）影响右侧上颌（V2）分裂的三叉神经。该模型具有许多优点，包括可以映射到已知的躯体位置解剖结构的特定变化的评价。根据感觉（体感皮层（SI和SII）、运动（MI）和后额叶）或情感（DLPFC、额叶、前岛、扣带回）疼痛处理选择皮质区域。在所有患者中，从间隔2-6个月的两次不同成像中获得结构和功能（刷引起的异常性疼痛）扫描并取平均值。年龄和性别匹配的健康对照组也进行了两次扫描，以测量皮质厚度。TNP患者皮质厚度的变化经常与功能性异常性疼痛激活相关，包括感觉运动区域的皮质增厚和变薄，主要是情感区域的变薄。总的来说，这种皮质厚度的模式表明大脑的动态功能驱动的可塑性。这些结构变化与疼痛持续时间、发病年龄、疼痛强度和皮层活动相关，可能是评估治疗干预的特定目标。
Recent data suggests that in chronic pain there are changes in gray matter consistent with decreased brain volume, indicating that the disease process may produce morphological changes in the brains of those affected. However, no study has evaluated cortical thickness in relation to specific functional changes in evoked pain. In this study we sought to investigate structural (gray matter thickness) and functional (blood oxygenation dependent level – BOLD) changes in cortical regions of precisely matched patients with chronic trigeminal neuropathic pain (TNP) affecting the right maxillary (V2) division of the trigeminal nerve. The model has a number of advantages including the evaluation of specific changes that can be mapped to known somatotopic anatomy. Cortical regions were chosen based on sensory (Somatosensory cortex (SI and SII), motor (MI) and posterior insula), or emotional (DLPFC, Frontal, Anterior Insula, Cingulate) processing of pain. Both structural and functional (to brush-induced allodynia) scans were obtained and averaged from two different imaging sessions separated by 2–6 months in all patients. Age and gender-matched healthy controls were also scanned twice for cortical thickness measurement. Changes in cortical thickness of TNP patients were frequently colocalized and correlated with functional allodynic activations, and included both cortical thickening and thinning in sensorimotor regions, and predominantly thinning in emotional regions. Overall, such patterns of cortical thickness suggest a dynamic functionally-driven plasticity of the brain. These structural changes, which correlated with the pain duration, age-at-onset, pain intensity and cortical activity, may be specific targets for evaluating therapeutic interventions.
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