Executive function in chronic pain patients and healthy controls: different cortical activation during response inhibition in fibromyalgia.
Executive function in chronic pain patients and healthy controls: different cortical activation during response inhibition in fibromyalgia.
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DOI：
10.1016/j.jpain.2011.06.007
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发表时间：
2011-12
期刊：
影响因子：
--
通讯作者：
Schmidt-Wilcke T
中科院分区：
文献类型：
--
作者：
Glass JM;Williams DA;Fernandez-Sanchez ML;Kairys A;Barjola P;Heitzeg MM;Clauw DJ;Schmidt-Wilcke T
纤维肌痛（FM）的主要症状是慢性、广泛性疼痛；然而，患者报告了其他症状，包括注意力和记忆力下降。表现缺陷主要出现在工作记忆和执行功能的测试中。研究人员对18例FM患者和14例年龄匹配的hc患者进行了功能性磁共振成像（fMRI），并对他们进行了简单的go/no-go任务（反应抑制）。在反应时间和准确性方面，调频和HC的表现没有差异。然而，fMRI显示，FM患者在右侧运动前皮质、辅助运动区（SMA）、中扣带皮质（MCC）、壳核以及在控制焦虑后，右侧岛叶皮质（IC）和右侧额下回（IFG）的激活较低。FM患者的右侧颞下回/梭状回高度激活。尽管具有相同的RTs和准确性，但FM患者在抑制网络（特别是涉及反应选择/运动准备的区域）和注意网络的皮质结构中表现出较少的大脑激活，同时在通常不属于抑制网络的大脑区域中表现出增加的激活。我们假设反应抑制和疼痛感知可能依赖于部分重叠的网络，并且在慢性疼痛患者中，疼痛处理所占用的资源可能无法用于执行功能任务，如反应抑制。补偿性皮质可塑性可能需要达到与对照组相当的表现。
The primary symptom of fibromyalgia (FM) is chronic, widespread pain; however, patients report additional symptoms including decreased concentration and memory. Performance based deficits are seen mainly in tests of working memory and executive function. Neural correlates of executive function were investigated in 18 FM patients and 14 age-matched HCs during a simple go/no-go task (response inhibition) while they underwent functional magnetic resonance imaging (fMRI). Performance was not different between FM and HC, in either reaction time or accuracy. However, fMRI revealed that FM patients had lower activation in the right pre-motor cortex, supplementary motor area (SMA), mid cingulate cortex (MCC), putamen and, after controlling for anxiety, in the right insular cortex (IC) and right inferior frontal gyrus (IFG). A hyper-activation in FM patients was seen in the right inferior temporal gyrus/fusiform gyrus. Despite the same RTs and accuracy, FM patients show less brain activation in cortical structures in the inhibition network (specifically in areas involved in response selection/motor preparation) and the attention network along with increased activation in brain areas not normally part of the inhibition network. We hypothesize that response -inhibition and pain perception may rely on partially overlapping networks, and that in chronic pain patients resources taken up by pain processing may not be available for executive functioning tasks such as response inhibition. Compensatory cortical plasticity may be required to achieve performance on par with control groups.
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