超越慢性疼痛阶段:默认模式网络扰动取决于背痛的年限。

IF 5.9 1区 医学 Q1 ANESTHESIOLOGY
PAIN® Pub Date : 2025-01-01 Epub Date: 2024-07-10 DOI:10.1097/j.pain.0000000000003335
Nils Jannik Heukamp, Vera Moliadze, Mina Mišić, Katrin Usai, Martin Löffler, Herta Flor, Frauke Nees
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引用次数: 0

摘要

摘要:研究表明,与健康对照组相比,慢性疼痛患者的默认模式网络(DMN)受到干扰,这种干扰与慢性疼痛阶段的疼痛持续时间相关。目前仍不清楚的是,DMN的适应是否在亚急性疼痛阶段就已显现,并随着疼痛持续时间的延长而逐渐发展,而不是慢性疼痛阶段的特定相关因素。此外,关于这些适应是否与认知适应过程有关的信息也很缺乏。为此,我们对 31 名慢性背痛(CBP)患者、77 名亚急性背痛(SBP)患者以及 39 名健康无痛对照组(HC)的 DMN 进行了研究,并在功能静息态磁共振成像上应用了图论网络方法。除了组间比较外,我们还对所有背痛患者的疼痛生活年限(YLP)进行了线性分析,并对认知性疼痛应对的作用进行了中介分析。与之前的研究一致,我们发现 CBP 与 HC 相比,DMN 有明显的扰动。然而,这并不适用于 CBP 与 SBP 的比较。相反,我们观察到 DMN 干扰与 YLP 之间存在正相关。这在很大程度上受对疼痛的应对态度的影响。因此,默认模式网络扰动可能反映了神经对疼痛体验的适应过程,而不是慢性疼痛阶段的单一相关因素,并受到认知适应的调节。这指出了可能未得到充分研究的重要适应过程,可以对患者进行更精细的分层。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Beyond the chronic pain stage: default mode network perturbation depends on years lived with back pain.

Abstract: Research has indicated that the default mode network (DMN) is perturbated in patients with chronic pain when compared with healthy controls, and this perturbation is correlated with the duration of pain during the chronic pain stage. It remains unclear whether DMN adaptations manifest during the subacute pain stage and progress over time because of the duration of pain experience, rather than being a specific correlate of the chronic pain stage. Furthermore, information regarding whether these adaptations are related to cognitive processes of adaptation is lacking. To this end, we examined the DMN in 31 patients with chronic back pain (CBP), 77 patients with subacute back pain (SBP), as well as 39 healthy pain-free controls (HC) applying a graph-theoretic network approach on functional resting-state magnetic resonance imaging. Beyond the comparison between groups, we used a linear analysis considering the years lived with pain (YLP) across all patients with back pain and additionally performed a mediation analysis of the role of cognitive pain coping. In line with previous studies, we found significant DMN perturbation in CBP compared with HC. However, this did not apply to the comparison of CBP with SBP. Instead, we observed a positive correlation between DMN perturbation and YLP. This was significantly mediated by coping attitudes towards pain. Default mode network perturbation may thus reflect neural adaptation processes to pain experience rather than a single correlate of the chronic pain stage and be modulated by cognitive adaption. This points to potentially underinvestigated significant adaptation processes that could enable more fine-grained patient stratification.

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来源期刊
PAIN®
PAIN® 医学-临床神经学
CiteScore
12.50
自引率
8.10%
发文量
242
审稿时长
9 months
期刊介绍: PAIN® is the official publication of the International Association for the Study of Pain and publishes original research on the nature,mechanisms and treatment of pain.PAIN® provides a forum for the dissemination of research in the basic and clinical sciences of multidisciplinary interest.
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