Functional and neurochemical disruptions of brain hub topology in chronic pain
Functional and neurochemical disruptions of brain hub topology in chronic pain
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DOI：
10.1097/j.pain.0000000000001480
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发表时间：
2019-04-01
期刊：
影响因子：
7.4
通讯作者：
Harris, Richard E.
中科院分区：
文献类型：
--
作者：
Kaplan, Chelsea M.;Schrepf, Andrew;Harris, Richard E.
脑网络结构的一个关键组件是一个健壮的中枢结构，其中中枢区域通过在网络中扮演高度连接和功能中心的角色来促进高效的信息集成。在一系列神经疾病中，中枢大脑区域似乎受到干扰，这种干扰的特征可以对这些疾病的病理生理学有深入的了解。我们应用了一种基于大脑网络的方法来检查纤维肌痛的中枢拓扑结构，纤维肌痛是一种慢性疼痛状况，有明显的中枢神经系统受累。使用图论技术分析了40名纤维肌痛患者和46名健康志愿者的静息状态功能磁共振成像数据，以及11名纤维肌痛患者的一小部分验证队列，以建立264个脑区之间的联系模型。在纤维肌痛中，前岛起着枢纽的作用，是RICH俱乐部的成员，RICH俱乐部是一个高度相互联系的枢纽网络。在纤维肌痛中，Rich-Club成员随临床疼痛强度的不同而不同：仅在疼痛强度最高的患者中，后脑岛、初级躯体感觉和运动皮质属于Rich俱乐部。此外，岛后的特征向量中心性(衡量一个区域与其他高度连接的区域的连接程度)与临床疼痛呈正相关，并中介了该结构中的谷氨酰胺1-谷氨酰胺(通过质子磁共振光谱评估)与患者的临床疼痛报告之间的关系。综上所述，这些发现揭示了纤维肌痛中枢拓扑结构的变化，并首次证明了据我们所知，中枢强度变化的神经化学基础及其与疼痛感知的关系。
A critical component of brain network architecture is a robust hub structure, wherein hub regions facilitate efficient information integration by occupying highly connected and functionally central roles in the network. Across a wide range of neurological disorders, hub brain regions seem to be disrupted, and the character of this disruption can yield insights into the pathophysiology of these disorders. We applied a brain network-based approach to examine hub topology in fibromyalgia, a chronic pain condition with prominent central nervous system involvement. Resting state functional magnetic resonance imaging data from 40 fibromyalgia patients and 46 healthy volunteers, and a small validation cohort of 11 fibromyalgia patients, were analyzed using graph theoretical techniques to model connections between 264 brain regions. In fibromyalgia, the anterior insulae functioned as hubs and were members of the rich club, a highly interconnected nexus of hubs. In fibromyalgia, rich-club membership varied with the intensity of clinical pain: the posterior insula, primary somatosensory, and motor cortices belonged to the rich club only in patients with the highest pain intensity. Furthermore, the eigenvector centrality (a measure of how connected a region is to other highly connected regions) of the posterior insula positively correlated with clinical pain and mediated the relationship between glutamate 1 glutamine (assessed by proton magnetic resonance spectroscopy) within this structure and the patient's clinical pain report. Together, these findings reveal altered hub topology in fibromyalgia and demonstrate, for the first time to our knowledge, a neurochemical basis for altered hub strength and its relationship to the perception of pain.