Neuropathic pain and pain interference are linked to alpha-band slowing and reduced beta-band magnetoencephalography activity within the dynamic pain connectome in patients with multiple sclerosis
Neuropathic pain and pain interference are linked to alpha-band slowing and reduced beta-band magnetoencephalography activity within the dynamic pain connectome in patients with multiple sclerosis
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DOI：
10.1097/j.pain.0000000000001391
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发表时间：
2019-01-01
期刊：
影响因子：
7.4
通讯作者：
Davis, Karen D.
中科院分区：
文献类型：
--
作者：
Kim, Junseok A.;Bosma, Rachael L.;Davis, Karen D.
慢性疼痛是多发性硬化症（MS）的常见症状，严重影响生活质量，但与这些症状相关的潜在脑机制尚不清楚。先前的脑电图研究已经证明了字母和β波段功率在疼痛处理中的作用。然而，在MS相关的慢性疼痛中，这些脑信号如何以及在何处变化尚不清楚。在这里，我们使用静息状态脑磁图检查区域频谱功率的动态疼痛连接，包括上行伤害性通路，默认模式网络（DMN），和显着性网络（SN）的地区，在慢性MS疼痛患者和健康对照。评估每例患者的疼痛、神经性疼痛（NP）和疼痛对日常生活活动的干扰。我们发现，MS患者表现出增加的α-波段功率和β-波段功率的减少，最显着的是在丘脑和后丘脑的上行伤害性通路和右颞顶交界处的SN。此外，混合型NP患者表现出丘脑和后丘脑以及DMN后扣带皮层的α峰功率减慢。最后，混合型NP患者的疼痛干扰评分与丘脑和后丘脑的α和β峰值功率密切相关。这些新的发现揭示了MS相关疼痛在上行伤害性通路、SN和DMN中的脑机制，并且这些光谱异常反映了疼痛对生活质量测量的影响。
Chronic pain is a common occurrence in multiple sclerosis (MS) that severely affects quality of life, but the underlying brain mechanisms related to these symptoms are unknown. Previous electroencephalography studies have demonstrated a role of alphaband and beta-band power in pain processing. However, how and where these brain signals change in MS-related chronic pain is unknown. Here, we used resting state magnetoencephalography to examine regional spectral power in the dynamic pain connectome-including areas of the ascending nociceptive pathway, default mode network (DMN), and the salience network (SN)-in patients with chronic MS pain and in healthy controls. Each patient was assessed for pain, neuropathic pain (NP), and pain interference with activities of daily living. We found that patients with MS exhibited an increase of alpha-band power and a decrease of beta-band power, most prominently in the thalamus and the posterior insula of the ascending nociceptive pathway and in the right temporoparietal junction of the SN. In addition, patients with mixed-NP exhibited slowing of alpha peak power within the thalamus and the posterior insula, and in the posterior cingulate cortex of the DMN. Finally, pain interference scores in patients with mixed-NP were strongly correlated with alpha and beta peak power in the thalamus and posterior insula. These novel findings reveal brain mechanisms of MS-related pain in the ascending nociceptive pathway, SN, and DMN, and that these spectral abnormalities reflect the impact of pain on quality of life measures.