The impact of Alzheimer's disease on the functional connectivity between brain regions underlying pain perception
The impact of Alzheimer's disease on the functional connectivity between brain regions underlying pain perception
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DOI：
10.1016/j.ejpain.2010.10.010
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发表时间：
2011-07-01
影响因子：
3.6
通讯作者：
Egan, Gary F.
中科院分区：
文献类型：
--
作者：
Cole, Leonie J.;Gavrilescu, Maria;Egan, Gary F.
与认知完整的同龄人相比，阿尔茨海默病（AD）患者使用的镇痛药较少，临床疼痛也较少，这促使人们猜测神经变性对疼痛感知和处理的可能影响。本研究使用功能连通性分析来检查AD对调节疼痛的感觉、情绪和认知方面的大脑区域综合功能的影响。14名AD患者和15名对照者参加了两个实验阶段。在最初的心理物理测试阶段，采用随机阶梯程序评估对施加在缩略图上的有害机械压力的敏感性。在随后的脑成像过程中，当参与者接受有害或无害的缩略图压力时，fMRI数据被收集，压力的强度与先前确定的主观疼痛阈值相对应。使用了两种功能连接分析方法。一种基于种子的相关方法首次用于识别与右背外侧前额叶皮层（DLPFC）具有显著功能连接的区域。然后评估17个预定义的疼痛处理区域网络之间的功能连通性。组间比较显示，与对照组相比，AD患者DLPFC与前中扣带皮层、导水管周围灰质、丘脑、下丘脑和几个运动区之间的功能连通性增强。同样，在患者组中，预定义疼痛网络的大多数区域的区域间功能连通性更大，功能连通性增强集中在三个节点上：DLPFC-R、下丘脑和PAG。这项研究的结果支持了先前的研究，即阿尔茨海默病患者的疼痛和认知过程之间存在相互作用。(C) 2010年欧洲国际疼痛研究协会联合会分会。Elsevier Ltd.出版。版权所有。
Patients with Alzheimer's disease (AD) are administered fewer analgesics and report less clinical pain compared with their cognitively-intact peers, prompting much speculation about the likely impact of neurodegeneration on pain perception and processing. This study used functional connectivity analysis to examine the impact of AD on the integrated functioning of brain regions mediating the sensory, emotional, and cognitive aspects of pain. Fourteen patients with AD and 15 controls attended two experimental sessions. In an initial psychophysical testing session, a random staircase procedure was used to assess sensitivity to noxious mechanical pressure applied to the thumbnail. In a subsequent brain imaging session, fMRI data were collected as participants received noxious or innocuous thumbnail pressure, delivered at intensities corresponding with previously identified subjective pain thresholds. Two approaches to functional connectivity analysis were utilised. A seed-based correlation method was first used to identify regions showing significant functional connectivity with the right dorsolateral prefrontal cortex (DLPFC). Functional connectivity between a network of 17 predefined pain processing regions was then assessed. Between-group comparisons revealed enhanced functional connectivity between the DLPFC and the anterior mid cingulate cortex, periaqueductal grey, thalamus, hypothalamus, and several motor areas in patients with AD compared with control group. Likewise, inter-regional functional connectivity across most regions of the predefined pain network was shown to be greater in the patient group, with the enhanced functional connectivity centred on three nodes: the DLPFC-R, hypothalamus, and PAG. The results of this study support previous research suggesting an interplay between pain and cognitive processes in patients with AD. (C) 2010 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.