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Investigation into the cerebral mechanisms of chronic pain using functional magnetic resonance imaging

使用功能磁共振成像研究慢性疼痛的脑机制

基本信息

批准号：
21592004
负责人：
KURATA Jiro
金额：
$ 2.83万
依托单位：
Kyoto University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2009
资助国家：
日本
起止时间：
2009 至 2011
项目状态：
已结题

项目摘要

We used lumbar mechanical stimulation and functional magnetic resonance imaging(fMRI) and found that cerebral substrates of low back pain are distributed at the insular, posterior cingulate, prefrontal cortices and premotor area. Low back pain patients showed significantly enhanced activation at the posterior cingulate cortex(PCC) compared with healthy volunteer subjects. The size of activation at the PCC depended on the intensity of lumbar mechanical stimulation. The enhanced PCC activation was associated with dysfunction of the surrounding default mode network in chronic low back pain patients, which might explain the pathophysiological background of cognitive dysfunction in those patients. In a different series of studies, fMRI successfully unveiled exaggerated activation over wide brain areas including the limbic system in neuropathic pain and, in contrast, normal somatosensory activation in psychogenic pain.In summary, chronic pain patients showed exaggerated activation at the cerebral substrates of pain perception in the limbic system, especially at the posterior cingulate cortex, and a sign of potentially disturbed function of the default mode network. Analysis of pain-related cerebral activation by fMRI might potentially give an objective clue to differentiate neuropathic and psychogenic pain.

我们采用腰椎机械刺激和功能磁共振成像（fMRI）发现腰痛的脑底物分布在岛叶、后扣带、前额叶皮层和运动前区。与健康志愿者相比，腰痛患者的后扣带皮层（PCC）激活明显增强。PCC的激活大小取决于腰椎机械刺激的强度。慢性腰痛患者PCC激活增强与周围默认模式网络功能障碍相关，这可能解释了慢性腰痛患者认知功能障碍的病理生理背景。在一系列不同的研究中，功能磁共振成像成功地揭示了在神经性疼痛中，包括边缘系统在内的广泛大脑区域的过度激活，相反，在心因性疼痛中，正常的躯体感觉激活。综上所述，慢性疼痛患者表现出边缘系统痛觉脑底物的过度激活，特别是后扣带皮层，这是默认模式网络功能潜在紊乱的迹象。通过功能磁共振成像分析疼痛相关的大脑活动，可能为区分神经性疼痛和心因性疼痛提供客观线索。