Brain dysfunction in chronic pain patients assessed by resting-state electroencephalography
Brain dysfunction in chronic pain patients assessed by resting-state electroencephalography
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DOI：
10.1097/j.pain.0000000000001666
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发表时间：
2019-12-01
期刊：
影响因子：
7.4
通讯作者：
Ploner, Markus
中科院分区：
文献类型：
--
作者：
Dinh, Son Ta;Nickel, Moritz M.;Ploner, Markus
慢性疼痛是一种常见的严重致残疾病，其治疗往往不能令人满意。对慢性疼痛的大脑机制的深入了解有望促进对潜在病理生理学的理解，并可能有助于开发疾病标志物和新的治疗方法。在这里，我们系统地利用脑电图的潜力来确定慢性疼痛静息状态下脑功能的异常。为此，我们对101名患有慢性疼痛的男女患者进行了最先进的脑振荡活动、脑连接和脑网络分析。结果表明，慢性疼痛患者和健康对照组之间的整体和局部脑活动测量没有差异。然而，我们观察到慢性疼痛患者额叶脑区域在theta （4- 8hz）和gamma （> - 60hz）频率下的连通性显著增加，以及gamma频率下的全球网络重组。此外，机器学习算法可以区分患者和健康对照，准确率高达57%，主要基于额叶连接。这些结果表明，额叶区增加的θ波和γ波同步参与了慢性疼痛的病理生理学。尽管研究结果的可重复性以及潜在的基于脑电图的疾病标志物的准确性、特异性和有效性仍有待克服，但我们的研究表明，在theta和gamma频率下的异常额叶同步可能是无创脑刺激和/或神经反馈方法的有希望的目标。
Chronic pain is a common and severely disabling disease whose treatment is often unsatisfactory. Insights into the brain mechanisms of chronic pain promise to advance the understanding of the underlying pathophysiology and might help to develop disease markers and novel treatments. Here, we systematically exploited the potential of electroencephalography to determine abnormalities of brain function during the resting state in chronic pain. To this end, we performed state-of-the-art analyses of oscillatory brain activity, brain connectivity, and brain networks in 101 patients of either sex suffering from chronic pain. The results show that global and local measures of brain activity did not differ between chronic pain patients and a healthy control group. However, we observed significantly increased connectivity at theta (4-8 Hz) and gamma (>60 Hz) frequencies in frontal brain areas as well as global network reorganization at gamma frequencies in chronic pain patients. Furthermore, a machine learning algorithm could differentiate between patients and healthy controls with an above-chance accuracy of 57%, mostly based on frontal connectivity. These results suggest that increased theta and gamma synchrony in frontal brain areas are involved in the pathophysiology of chronic pain. Although substantial challenges concerning the reproducibility of the findings and the accuracy, specificity, and validity of potential electroencephalography-based disease markers remain to be overcome, our study indicates that abnormal frontal synchrony at theta and gamma frequencies might be promising targets for noninvasive brain stimulation and/or neurofeedback approaches.