Acute changes in functional connectivity associated with first osteopathic manual treatment in chronic low back pain spatially overlap with opioid receptor expression

IF 3.5 3区医学 Q2 NEUROSCIENCES

Brain Research Bulletin Pub Date : 2025-05-11 DOI:10.1016/j.brainresbull.2025.111375

Federica Tomaiuolo , Francesco Cerritelli , Carlo Sestieri , Jordan Keys , Teresa Paolucci , Stefano L. Sensi , Antonio Ferretti , Stefano Delli Pizzi

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引用次数: 0

Abstract

Background

Osteopathic Manipulative Treatment (OMT) has emerged as a therapeutic approach for chronic low back pain (cLBP). Previous Magnetic Resonance (MR) studies have demonstrated that four weeks of OMT alter resting-state functional connectivity (rs-FC) in the somatosensory cortex, prefrontal regions, and frontal operculum/insula. However, it remains unclear whether a single session of OMT can immediately affect brain rs-FC.

Methods

We combined a data-driven approach with a seed-based connectivity analysis to examine the pattern of whole-brain rs-FC in a cohort of thirty cLBP patients before and after a first acute session of OMT (N = 16) or a sham treatment (N = 14). Correlation analyses were performed to explore the relationship between the resulting rs-FC maps and receptor density/gene expression maps derived from in vivo brain atlases, focusing on the opioid and cannabinoid systems.

Results

Data-driven analysis revealed that, compared to the sham group, the OMT increased the intrinsic connectivity of the right dorsolateral prefrontal cortex. Seed-based connectivity analysis showed that this region increased coupling with the right frontal operculum/insula. Notably, no effect of immediate OMT was found in the somatosensory cortex. The topography of these rs-FC changes selectively overlapped with the distribution of mu-opioid receptors.

Conclusions

Acute OMT in cLBP patients modulates rs-FC across cortical regions primarily involved in top-down cognitive control of pain, as well as in integrating pain intensity perception and related expectations. Spatial comparisons between rs-FC maps and receptor atlases suggest that these neural changes involve opioid, not cannabinoid, neurotransmission.

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慢性腰痛患者首次骨疗法治疗后功能连通性的急性改变在空间上与阿片受体表达重叠

背景：推拿疗法（OMT）已成为慢性腰痛（cLBP）的一种治疗方法。先前的磁共振（MR）研究表明，四周的OMT改变了体感皮层、前额叶区域和额盖/脑岛的静息状态功能连接（rs-FC）。然而，目前尚不清楚单次OMT是否会立即影响大脑rs-FC。方法：我们将数据驱动方法与基于种子的连通性分析相结合，研究了30名cLBP患者在首次急性OMT （N = 16）或假治疗（N = 14）前后的全脑rs-FC模式。研究人员通过相关分析探讨了rs-FC图谱与体内脑图谱中受体密度/基因表达图谱之间的关系，重点研究了阿片和大麻素系统。结果数据驱动分析显示，与假手术组相比，OMT增加了右背外侧前额叶皮层的内在连通性。基于种子的连通性分析表明，该区域与右侧额叶盖/脑岛的耦合增加。值得注意的是，在体感觉皮层中没有发现立即OMT的影响。这些rs-FC的地形变化选择性地与mu-阿片受体的分布重叠。结论cLBP患者的急性OMT通过皮质区域调节rs-FC，主要参与自上而下的疼痛认知控制，以及整合疼痛强度感知和相关预期。rs-FC图谱和受体图谱之间的空间比较表明，这些神经变化涉及阿片样物质而非大麻素神经传递。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain Research Bulletin 医学-神经科学

CiteScore

6.90

自引率

2.60%

发文量

253

审稿时长

67 days

期刊介绍： The Brain Research Bulletin (BRB) aims to publish novel work that advances our knowledge of molecular and cellular mechanisms that underlie neural network properties associated with behavior, cognition and other brain functions during neurodevelopment and in the adult. Although clinical research is out of the Journal''s scope, the BRB also aims to publish translation research that provides insight into biological mechanisms and processes associated with neurodegeneration mechanisms, neurological diseases and neuropsychiatric disorders. The Journal is especially interested in research using novel methodologies, such as optogenetics, multielectrode array recordings and life imaging in wild-type and genetically-modified animal models, with the goal to advance our understanding of how neurons, glia and networks function in vivo.