Arthritic pain is processed in brain areas concerned with emotions and fear
Arthritic pain is processed in brain areas concerned with emotions and fear
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DOI：
10.1002/art.22460
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发表时间：
2007-04-01
影响因子：
--
通讯作者：
Jones, A. K. P.
中科院分区：
文献类型：
--
作者：
Kulkarni, B.;Bentley, D. E.;Jones, A. K. P.
客观的。功能性神经影像学研究表明，实验诱发的急性疼痛是在至少 2 个平行的大脑结构网络（统称为疼痛矩阵）内进行处理的。这一发现与临床疼痛的相关性尚不清楚，因为尚未在同一组患者中对实验疼痛和临床疼痛进行直接比较。本研究的目的是直接比较一组骨关节炎 (OA) 患者处理关节炎疼痛和实验性疼痛的大脑区域。方法。 12 名膝关节 OA 患者使用 (18) F-氟脱氧葡萄糖 (FDG) 进行了脑部正电子发射断层扫描。在 3 种不同的疼痛状态下进行扫描：关节炎膝盖疼痛、实验性膝盖疼痛和无痛。使用统计参数绘图软件研究了不同疼痛状态之间神经元摄取 FDG 的显着差异。结果。两种疼痛都会激活疼痛基质，但关节炎疼痛与扣带皮层、丘脑和杏仁核的活动增加有关；这些区域涉及恐惧、情绪和厌恶条件的处理。结论。我们的结果表明，对实验性疼痛的研究提供了关节炎疼痛期间大脑活动的相关但定量上不完整的图像。寻找作用于大脑的关节炎新镇痛药应该集中于改变这一回路的药物。
Objective. Functional neuroimaging studies have shown that experimentally induced acute pain is processed within at least 2 parallel networks of brain structures collectively known as the pain matrix. The relevance of this finding to clinical pain is not known, because no direct comparisons of experimental and clinical pain have been performed in the same group of patients. The aim of this study was to compare directly the brain areas involved in processing arthritic pain and experimental pain in a group of patients with osteoarthritis (OA).Methods. Twelve patients with knee OA underwent positron emission tomography of the brain, using (18) F-fluorodeoxyglucose (FDG). Scanning was performed during 3 different pain states: arthritic knee pain, experimental knee pain, and pain-free. Significant differences in the neuronal uptake of FDG between different pain states were investigated using statistical parametric mapping software.Results. Both pain conditions activated the pain matrix, but arthritic pain was associated with increased activity in the cingulate cortex, the thalamus, and the amygdala; these areas are involved in the processing of fear, emotions, and in aversive conditioning.Conclusion. Our results suggest that studies of experimental pain provide a relevant but quantitatively incomplete picture of brain activity during arthritic pain. The search for new analgesics for arthritis that act on the brain should focus on drugs that modify this circuitry.