针灸对慢性神经性疼痛的调节及其与大脑功能特性的关系

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain Pub Date : 2024-07-30 DOI:10.1016/j.jpain.2024.104645

Xiao-Ya Wei , Xu Wang , Guang-Xia Shi , Jian-Feng Tu , Jing-Wen Yang , Meng-Meng Ren , Jun-Lian Liu , Chih-Kai Lee , Hang Zhou , Ze-Yi Wang , Cun-Zhi Liu

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引用次数: 0

摘要

慢性神经病理性疼痛是导致残疾的主要原因之一，而针灸在治疗方面已显示出良好的前景。本研究旨在描述针灸对慢性神经病理性疼痛的调节作用，并探讨相关的脑功能变化。60 名慢性坐骨神经痛患者被分为针刺组和假针刺组，在 4 周内接受 10 次治疗。在基线和治疗后评估腿痛视觉模拟量表（VAS）、Oswestry残疾指数（ODI）和静息态功能磁共振图像。然后进行低频波动分数振幅（fALFF）和支持向量回归（SVR）分析。与假针灸相比，针灸能明显改善症状，包括腿部疼痛 VAS 和 ODI。此外，针灸还增加了右顶叶上小叶（SPL）和右中央后回（PoCG）的fALFF。此外，4 周的实际 ODI 值与根据右侧 SPL fALFF 和基线临床测量结果得出的 SVR 预测值呈正相关。这些结果表明，右侧 SPL 和右侧 PoCG 的自发神经活动可能参与了针灸对慢性神经病理性疼痛的调节。此外，右侧SPL的自发神经活动可作为针灸治疗反应的预测指标。试验注册号：中国临床试验注册中心，ChiCTR2100044585，http://www.chictr.org.cn 观点：这项临床神经影像学研究阐明了针刺治疗慢性坐骨神经痛的神经基础。神经学指标和临床测量可作为针灸反应的潜在预测指标。这项研究结合了神经影像学和人工智能技术，突出了针灸治疗慢性神经病理性疼痛的潜力。

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Acupuncture Modulation of Chronic Neuropathic Pain and Its Association With Brain Functional Properties

Chronic neuropathic pain has been one of the prominent causes of disability, and acupuncture has shown promise in treatment. The present study aimed to characterize acupuncture modulation of chronic neuropathic pain and explore the related functional brain changes. Sixty chronic sciatica patients were divided into acupuncture- or sham acupuncture groups and received 10 sessions of treatment during 4 weeks. The visual analog scale for leg pain, oswestry disability index (ODI), and resting-state functional magnetic resonance images were assessed at baseline and after treatment. Then, fractional amplitudes of low-frequency fluctuations (fALFF) and support vector regression analyses were performed. Compared with sham acupuncture, acupuncture significantly improved symptoms, including visual analog scale for leg pain and ODI. In addition, acupuncture exhibited increased fALFF of the right superior parietal lobule (SPL) and right postcentral gyrus. Furthermore, the actual 4-week ODI values were positively correlated with the support vector regression-predicted values based on the right SPL fALFF and baseline clinical measurements. These results indicate that the spontaneous neural activity of the right SPL and right postcentral gyrus may be involved in the modulation of acupuncture in chronic neuropathic pain. In addition, the spontaneous neural activity of the right SPL might be used as the predictor of response to acupuncture therapy.

Perspective

This clinical neuroimaging study elucidated the neural basis of acupuncture in chronic sciatica. Neurological indicators and clinical measurements could be used as potential predictors of acupuncture response. This study combines neuroimaging and artificial intelligence techniques to highlight the potential of acupuncture for the treatment of chronic neuropathic pain.

Trial registration number

Chinese Clinical Trial Registry, ChiCTR2100044585, http://www.chictr.org.cn.

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来源期刊

Journal of Pain 医学-临床神经学

CiteScore

6.30

自引率

7.50%

发文量

441

审稿时长

42 days

期刊介绍： The Journal of Pain publishes original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. Articles selected for publication in the Journal are most commonly reports of original clinical research or reports of original basic research. In addition, invited critical reviews, including meta analyses of drugs for pain management, invited commentaries on reviews, and exceptional case studies are published in the Journal. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research.