PDF(Pubmed)
Abstract：
UNASSIGNED: Chronic low back pain (cLBP) is a recurring and intractable disease that is often accompanied by emotional and cognitive disorders such as depression and anxiety. The nucleus accumbens (NAc) plays an important role in mediating emotional and cognitive processes and analgesia. This study investigated the resting-state functional connectivity (rsFC) and effective connectivity (EC) of NAc and its subregions in cLBP.
UNASSIGNED: Thirty-four cLBP patients and 34 age- and sex-matched healthy controls (HC) underwent resting-state functional magnetic resonance imaging (rs-fMRI). Seed-based rsFC and Dynamic Causal Modelling (DCM) were used to examine the alteration of the rsFC and EC of the NAc.
UNASSIGNED: Our results showed that the cLBP group had increased rsFC of the bilateral NAc-left superior frontal cortex (SFC), orbital frontal cortex (OFC), left angular gyrus, the left NAc-bilateral middle temporal gyrus, as well as decreased rsFC of left NAc-left supramarginal gyrus, right precentral gyrus, left cerebellum, brainstem (medulla oblongata), and right insula pathways compared with the HC; the results of the subregions were largely consistent with the whole NAc. In addition, the rsFC of the left NAc-left SFC was negatively correlated with Hamilton\'s Depression Scale (HAMD) scores (r = -0.402, p = 0.018), and the rsFC of left NAc-OFC was positively correlated with present pain intensity scores (r = 0.406, p = 0.017) in the cLBP group. DCM showed that the cLBP group showed significantly increased EC from the left cerebellum to the right NAc (p = 0.012) as compared with HC.
UNASSIGNED: Overall, our findings demonstrate aberrant rsFC and EC between NAc and regions that are associated with emotional regulation and cognitive processing in individuals with cLBP, underscoring the pivotal roles of emotion and cognition in cLBP.
UNASSIGNED: Thirty-four cLBP patients and 34 age- and sex-matched healthy controls (HC) underwent resting-state functional magnetic resonance imaging (rs-fMRI). Seed-based rsFC and Dynamic Causal Modelling (DCM) were used to examine the alteration of the rsFC and EC of the NAc.
UNASSIGNED: Our results showed that the cLBP group had increased rsFC of the bilateral NAc-left superior frontal cortex (SFC), orbital frontal cortex (OFC), left angular gyrus, the left NAc-bilateral middle temporal gyrus, as well as decreased rsFC of left NAc-left supramarginal gyrus, right precentral gyrus, left cerebellum, brainstem (medulla oblongata), and right insula pathways compared with the HC; the results of the subregions were largely consistent with the whole NAc. In addition, the rsFC of the left NAc-left SFC was negatively correlated with Hamilton\'s Depression Scale (HAMD) scores (r = -0.402, p = 0.018), and the rsFC of left NAc-OFC was positively correlated with present pain intensity scores (r = 0.406, p = 0.017) in the cLBP group. DCM showed that the cLBP group showed significantly increased EC from the left cerebellum to the right NAc (p = 0.012) as compared with HC.
UNASSIGNED: Overall, our findings demonstrate aberrant rsFC and EC between NAc and regions that are associated with emotional regulation and cognitive processing in individuals with cLBP, underscoring the pivotal roles of emotion and cognition in cLBP.
摘要：
■慢性腰痛（cLBP）是一种反复发作且难以治疗的疾病，通常伴有抑郁和焦虑等情绪和认知障碍。伏隔核（NAc）在情绪和认知过程以及镇痛中起重要作用。本研究调查了cLBP中NAc及其亚区域的静息态功能连通性（rsFC）和有效连通性（EC）。
■34名cLBP患者和34名年龄和性别匹配的健康对照（HC）接受了静息状态功能磁共振成像（rs-fMRI）。基于种子的rsFC和动态因果模型（DCM）用于检查NAc的rsFC和EC的变化。
■我们的结果表明，cLBP组双侧NAc-左上额叶皮质（SFC）的rsFC增加，眶额叶皮质(OFC),左角回,左NAc-双侧颞中回,以及左NAc-左缘上回的rsFC减少，右中前回,左小脑,脑干（延髓），与HC相比，右岛途径；子区域的结果与整个NAc基本一致。此外,左NAc-左SFC的rsFC与汉密尔顿抑郁量表（HAMD）评分呈负相关（r=-0.402，p=0.018），cLBP组左侧NAc-OFC的rsFC与当前疼痛强度评分呈正相关（r=0.406，p=0.017）。DCM显示，与HC相比，cLBP组显示出从左小脑到右NAc的EC显着增加（p=0.012）。
■总的来说，我们的研究结果表明，在患有cLBP的个体中，NAc和与情绪调节和认知过程相关的区域之间存在异常的rsFC和EC，强调情绪和认知在cLBP中的关键作用。
■34名cLBP患者和34名年龄和性别匹配的健康对照（HC）接受了静息状态功能磁共振成像（rs-fMRI）。基于种子的rsFC和动态因果模型（DCM）用于检查NAc的rsFC和EC的变化。
■我们的结果表明，cLBP组双侧NAc-左上额叶皮质（SFC）的rsFC增加，眶额叶皮质(OFC),左角回,左NAc-双侧颞中回,以及左NAc-左缘上回的rsFC减少，右中前回,左小脑,脑干（延髓），与HC相比，右岛途径；子区域的结果与整个NAc基本一致。此外,左NAc-左SFC的rsFC与汉密尔顿抑郁量表（HAMD）评分呈负相关（r=-0.402，p=0.018），cLBP组左侧NAc-OFC的rsFC与当前疼痛强度评分呈正相关（r=0.406，p=0.017）。DCM显示，与HC相比，cLBP组显示出从左小脑到右NAc的EC显着增加（p=0.012）。
■总的来说，我们的研究结果表明，在患有cLBP的个体中，NAc和与情绪调节和认知过程相关的区域之间存在异常的rsFC和EC，强调情绪和认知在cLBP中的关键作用。
