Investigating the brain functional abnormalities underlying pain hypervigilance in chronic neck and shoulder pain: a resting-state fMRI study,Neuroradiology

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Investigating the brain functional abnormalities underlying pain hypervigilance in chronic neck and shoulder pain: a resting-state fMRI study
Neuroradiology ( IF 2.4 ) Pub Date : 2024-02-01 , DOI: 10.1007/s00234-024-03286-2
Jiyang Zhang ₁ , Hao Wang ₁ , Lin Guo ₁

Affiliation

Purpose

To investigate pain hypervigilance in individuals suffering from chronic neck and shoulder pain (CNSP) and its underlying brain mechanism.

Methods

The evaluation of pain vigilance was conducted through the utilization of pain vigilance and awareness questionnaires. Voxel-wise regional homogeneity (ReHo) from 60 CNSP patients and 60 healthy controls (HCs) using resting-state fMRI data. Voxel-wise two-sample T-test was conducted to reveal the ReHo variations between CNSP and HC. Correlation analyses were utilized to reveal the connection between brain abnormalities and medical measurements. Furthermore, a mediation analysis was conducted to elucidate the pathway-linking changes in brain function with medical measurements.

Results

Our present study revealed three main findings. Firstly, patients with CSNP demonstrated a heightened vigilance of pain in comparison to healthy adults, a common occurrence among individuals with chronic pain conditions. Secondly, we observed brain abnormalities in various brain regions in CSNP patients, and these alterations were associated with the extent of pain vigilance. Lastly, the pain hypervigilance impact on the severity of pain was found to be controlled by regional neural activity in the anterior cingulate cortex (ACC) in subjects with CSNP.

Conclusion

Our findings suggested that long-term repetitive nociceptive input caused by chronic pain further aggravates the pain intensity by impairing the vigilance-related pain processing within the anterior cingulate cortex in CNSP patients.

中文翻译：

调查慢性颈肩痛中疼痛过度警觉背后的大脑功能异常：一项静息态功能磁共振成像研究

目的

调查患有慢性颈肩痛 (CNSP) 的个体对疼痛的过度警惕及其潜在的大脑机制。

方法

通过利用疼痛警惕性和认知问卷来评估疼痛警惕性。使用静息态 fMRI 数据对 60 名 CNSP 患者和 60 名健康对照 (HC) 进行体素区域均匀性 (ReHo)。进行体素两样本T检验以揭示 CNSP 和 HC 之间的 ReHo 变化。利用相关分析来揭示大脑异常与医学测量之间的联系。此外，还进行了中介分析，以阐明大脑功能变化与医学测量之间的联系途径。

结果

我们目前的研究揭示了三个主要发现。首先，与健康成年人相比，CSNP 患者表现出对疼痛的高度警惕，这在慢性疼痛患者中很常见。其次，我们观察到CSNP患者各个脑区的大脑异常，这些改变与疼痛警惕程度相关。最后，发现 CSNP 受试者的疼痛过度警惕对疼痛严重程度的影响是由前扣带皮层 (ACC) 的区域神经活动控制的。