Towards a neurophysiological signature for fibromyalgia.
Towards a neurophysiological signature for fibromyalgia.
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DOI：
10.1097/j.pain.0000000000000707
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发表时间：
2017-01
期刊：
影响因子：
7.4
通讯作者：
Wager TD
中科院分区：
文献类型：
--
作者：
López-Solà M;Woo CW;Pujol J;Deus J;Harrison BJ;Monfort J;Wager TD
纤维肌痛(FM)患者对疼痛和非疼痛感觉的不适感明显增强，并伴有神经反应的改变。这种神经改变的诊断潜力，包括它们对FM(与健康对照)的敏感性和特异性尚不清楚。我们确定了一个大脑特征，它在神经系统水平上表征FM中枢病理生理学。我们包括37名FM患者和35名匹配的健康对照，分析了fMRI对(I)痛苦的压力和(Ii)非痛苦的多感觉(视觉-听觉-触觉)刺激的反应。我们使用机器学习技术来识别基于大脑的FM签名。当暴露在相同的疼痛刺激下时，FM患者表现出更大的神经疼痛特征(NPS，Wager 2013)。此外，一个新的疼痛相关分类器(FM-Pain)显示，FM的感觉整合(岛/盖)和自我参照(例如，前额内侧)区域的反应增强，而额叶外侧皮质的反应减少。对非痛性感觉刺激进行训练的“多感觉”分类器显示，在脑岛/盖、扣带后和前额内侧区域的反应增强，而在初级/次级感觉皮质、基底节和小脑的反应减弱。在样本外个体中，NPS、FM-Pain和多感觉模式的联合活动将患者与对照组进行分类，敏感度和特异度分别为92%和94%。NPS反应增强部分介导了机械超敏反应，并与抑郁和残疾相关(P<0.05)；FM-疼痛和多感觉反应与临床疼痛相关(P<0.05)。这项研究提供了基于病理生理和症状相关的脑特征的个体FM患者的初步特征。如果复制，这些大脑特征可能成为治疗干预的客观神经靶点。这些结果为评估治疗机制和预测个人层面的治疗反应建立了一个框架。
Fibromyalgia (FM) patients show characteristically enhanced unpleasantness to painful and non-painful sensations accompanied by altered neural responses. The diagnostic potential of such neural alterations, including their sensitivity and specificity to FM (vs. healthy controls) is unknown. We identify a brain signature that characterizes FM central pathophysiology at the neural systems level. We included 37 FM patients and 35 matched healthy controls, and analyzed fMRI responses to (i) painful pressure and (ii) non-painful multisensory (visual-auditory-tactile) stimulation. We used machine-learning techniques to identify a brain-based FM signature. When exposed to the same painful stimuli, FM patients showed greater Neurologic Pain Signature (NPS, Wager 2013) responses. In addition, a new pain-related classifier (‘FM-pain’) revealed augmented responses in sensory integration (insula/operculum) and self-referential (e.g., medial prefrontal) regions in FM, and reduced responses in the lateral frontal cortex. A ‘Multisensory’ classifier trained on non-painful sensory stimulation revealed augmented responses in insula/operculum, posterior cingulate, and medial prefrontal regions, and reduced responses in primary/secondary sensory cortices, basal ganglia and cerebellum. Combined activity in the NPS, FM-pain, and Multisensory patterns classified patients vs. controls with 92% sensitivity and 94% specificity in out-of-sample individuals. Enhanced NPS responses partly mediated mechanical hypersensitivity, and correlated with depression and disability(puncorrected<0.05); FM-pain and Multisensory responses correlated with clinical pain(puncorrected<0.05). The study provides initial characterization of individual FM-patients based on pathophysiological, symptom-related brain features. If replicated, these brain features may constitute objective neural targets for therapeutic interventions. The results establish a framework for assessing therapeutic mechanisms and predicting treatment response at the individual level.
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影响因子：
7.4
作者：
Hollins M;Harper D;Gallagher S;Owings EW;Lim PF;Miller V;Siddiqi MQ;Maixner W
通讯作者：
Maixner W
DOI：
10.1523/jneurosci.1984-11.2011
发表时间：
2011-09-28
期刊：
The Journal of neuroscience : the official journal of the Society for Neuroscience
影响因子：
--
作者：
Baliki MN;Baria AT;Apkarian AV
通讯作者：
Apkarian AV
影响因子：
4
作者：
Carrillo-de-la-Pena, M. T.;Vallet, M.;Gomez-Perretta, C.
通讯作者：
Gomez-Perretta, C.
影响因子：
5.3
作者：
Baliki, Marwan N.;Chialvo, Dante R.;Apkarian, A. Vania
通讯作者：
Apkarian, A. Vania
影响因子：
4
作者：
Alanoglu, E;Ulas, UH;Vural, O
通讯作者：
Vural, O