Brain Structure and Function of Chronic Low Back Pain Patients on Long-Term Opioid Analgesic Treatment: A Preliminary Study.
Brain Structure and Function of Chronic Low Back Pain Patients on Long-Term Opioid Analgesic Treatment: A Preliminary Study.
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DOI：
10.1177/1744806921990938
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发表时间：
2021-01
期刊：
影响因子：
3.3
通讯作者：
Geha P
中科院分区：
文献类型：
--
作者：
Murray K;Lin Y;Makary MM;Whang PG;Geha P
慢性腰痛（CLBP）常使用阿片类镇痛药（OA）进行治疗，这类药物具有显著的滥用风险。然而，对于OA治疗如何影响慢性疼痛患者的大脑，我们知之甚少。了解这方面的知识是理解OA相关镇痛作用以及阐明OA滥用长期风险的必要第一步。在此，我们对长期使用阿片类药物且无滥用迹象的慢性腰痛患者进行研究，并将他们与未使用阿片类药物的慢性腰痛患者以及健康对照组进行比较，采用的方法是大脑结构与功能成像。使用OA治疗的慢性腰痛患者在伏隔核和丘脑出现体积减小，并且其皮质下区域的信噪比总体显著下降。对伏隔核静息态活动频率成分的功率谱密度分析（PSD）显示，用药和未用药的患者在慢 - 5频段（0.01 - 0.027Hz）内均出现PSD降低，而只有使用OA的慢性腰痛患者在慢 - 4频段（0.027 - 0.073Hz）内还出现了密度进一步降低。我们得出结论，长期使用OA治疗与感觉边缘系统区域内大脑结构和功能的改变有关。
Chronic low back pain (CLBP) is often treated with opioid analgesics (OA), a class of medications associated with a significant risk of misuse. However, little is known about how treatment with OA affect the brain in chronic pain patients. Gaining this knowledge is a necessary first step towards understanding OA associated analgesia and elucidating long-term risk of OA misuse. Here we study CLBP patients chronically medicated with opioids without any evidence of misuse and compare them to CLBP patients not on opioids and to healthy controls using structural and functional brain imaging. CLBP patients medicated with OA showed loss of volume in the nucleus accumbens and thalamus, and an overall significant decrease in signal to noise ratio in their sub-cortical areas. Power spectral density analysis (PSD) of frequency content in the accumbens’ resting state activity revealed that both medicated and unmedicated patients showed loss of PSD within the slow-5 frequency band (0.01–0.027 Hz) while only CLBP patients on OA showed additional density loss within the slow-4 frequency band (0.027–0.073 Hz). We conclude that chronic treatment with OA is associated with altered brain structure and function within sensory limbic areas.
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影响因子：
16.2
作者：
Baliki, Marwan N.;Geha, Paul Y.;Fields, Howard L.;Apkarian, A. Vania
通讯作者：
Apkarian, A. Vania
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：
5.3
作者：
Baliki, Marwan N.;Chialvo, Dante R.;Apkarian, A. Vania
通讯作者：
Apkarian, A. Vania
影响因子：
4.8
作者：
Geoffroy, Helene;Canestrelli, Corinne;Noble, Florence
通讯作者：
Noble, Florence
DOI：
10.3122/jabfm.2011.06.100232
发表时间：
2011-11-01
影响因子：
2.9
作者：
Deyo, Richard A.;Smith, David H. M.;Dobscha, Steven K.
通讯作者：
Dobscha, Steven K.