Abstract：
BACKGROUND: Chronic inflammatory joint diseases (CIJD) have been linked to increased cardiovascular morbidity and mortality. A decisive reason could be a dysregulation of the autonomic nervous system, which is responsible for the control of cardiovascular function. So far, the cause of changes in autonomic nervous system functions remains elusive. In this study, we investigate the role of chronic pain and the insular cortex in autonomic control of cardiac functioning in patients with CIJD.
METHODS: We studied the autonomic nervous system through the assessment of heart rate and heart rate variability (HRV) at rest and under cognitive stimulation. Furthermore, we investigated insular cortex volume by performing surface-based brain morphometry with FreeSurfer. For this study, 47 participants were recruited, 22 individual age- and sex-matched pairs for the magnetic resonance imaging analyses and 14 for the HRV analyses. All available patients\' data were used for analysis.
RESULTS: Pain duration was negatively correlated with the resting heart rate in patients with chronic inflammatory joint diseases (n = 20). In a multiple linear regression model including only CIJD patients with heart rate at rest as a dependent variable, we found a significant positive relationship between heart rate at rest and the volume of the left insular cortex and a significant negative relationship between heart rate at rest and the volume of the right insular cortex. However, we found no significant differences in HRV parameters or insular cortex volumes between both groups.
CONCLUSIONS: In this study we provide evidence to suggest insular cortex involvement in the process of ANS changes due to chronic pain in CIJD patients. The study was preregistered with the German Clinical Trials Register ( https://www.drks.de ; DRKS00012791; date of registration: 28 July 2017).
METHODS: We studied the autonomic nervous system through the assessment of heart rate and heart rate variability (HRV) at rest and under cognitive stimulation. Furthermore, we investigated insular cortex volume by performing surface-based brain morphometry with FreeSurfer. For this study, 47 participants were recruited, 22 individual age- and sex-matched pairs for the magnetic resonance imaging analyses and 14 for the HRV analyses. All available patients\' data were used for analysis.
RESULTS: Pain duration was negatively correlated with the resting heart rate in patients with chronic inflammatory joint diseases (n = 20). In a multiple linear regression model including only CIJD patients with heart rate at rest as a dependent variable, we found a significant positive relationship between heart rate at rest and the volume of the left insular cortex and a significant negative relationship between heart rate at rest and the volume of the right insular cortex. However, we found no significant differences in HRV parameters or insular cortex volumes between both groups.
CONCLUSIONS: In this study we provide evidence to suggest insular cortex involvement in the process of ANS changes due to chronic pain in CIJD patients. The study was preregistered with the German Clinical Trials Register ( https://www.drks.de ; DRKS00012791; date of registration: 28 July 2017).
摘要：
背景：慢性炎症性关节疾病（CIJD）与心血管发病率和死亡率增加有关。一个决定性的原因可能是自主神经系统的失调，负责控制心血管功能。到目前为止,自主神经系统功能变化的原因仍然难以捉摸。在这项研究中,我们研究了慢性疼痛和岛叶皮质在CIJD患者心脏功能自主神经控制中的作用。
方法：我们通过评估休息和认知刺激下的心率和心率变异性（HRV）来研究自主神经系统。此外，我们通过使用FreeSurfer进行基于表面的脑形态测量研究了岛叶皮层的体积。对于这项研究，招募了47名参与者，22个年龄和性别匹配的个体对用于磁共振成像分析，14个用于HRV分析。所有可用的患者数据用于分析。
结果：慢性炎症性关节疾病患者的疼痛持续时间与静息心率呈负相关（n=20）。在多元线性回归模型中，仅包括以静息心率为因变量的CIJD患者，我们发现静息时的心率与左岛叶皮层的体积之间存在显著正相关，静息时的心率与右岛叶皮层的体积之间存在显著负相关。然而,我们发现两组间HRV参数或岛叶皮质体积无显著差异.
结论：在这项研究中，我们提供的证据表明岛叶皮质参与了CIJD患者慢性疼痛引起的ANS变化过程。该研究已在德国临床试验注册中心（https://www.drks.de；DRKS00012791；注册日期：2017年7月28日）。
方法：我们通过评估休息和认知刺激下的心率和心率变异性（HRV）来研究自主神经系统。此外，我们通过使用FreeSurfer进行基于表面的脑形态测量研究了岛叶皮层的体积。对于这项研究，招募了47名参与者，22个年龄和性别匹配的个体对用于磁共振成像分析，14个用于HRV分析。所有可用的患者数据用于分析。
结果：慢性炎症性关节疾病患者的疼痛持续时间与静息心率呈负相关（n=20）。在多元线性回归模型中，仅包括以静息心率为因变量的CIJD患者，我们发现静息时的心率与左岛叶皮层的体积之间存在显著正相关，静息时的心率与右岛叶皮层的体积之间存在显著负相关。然而,我们发现两组间HRV参数或岛叶皮质体积无显著差异.
结论：在这项研究中，我们提供的证据表明岛叶皮质参与了CIJD患者慢性疼痛引起的ANS变化过程。该研究已在德国临床试验注册中心（https://www.drks.de；DRKS00012791；注册日期：2017年7月28日）。
