目的:神经性疼痛(NP)是脊髓损伤(SCI)后的一种使人衰弱的疾病。导水管周围灰质(PAG)在SCI后NP发育中的作用仍未得到充分研究。使用静息状态功能磁共振成像(rsfMRI),我们的研究旨在证明SCI后NP中PAG的功能连接(FC)的变化。
方法:10例SCI患者(SCI+NP,n=7,SCI-NP,n=3),与10个健康对照(HCs)一起,已注册。进行rsfMRI,然后使用PAG作为种子区域进行种子-体素分析,然后进行包括三组(SCINP,SCI-NP,和HC)。年龄和性别被认为是混杂变量。
结果:与HC相比,SCI+NP显示PAG和右脑岛之间的FC降低,右额叶眶皮质,右苍白球,中缝背核(DRN),红核(RN),黑质(SN),和腹侧后外侧(VPL)丘脑核。与SCI-NP相比,SCI+NP显示PAG和后扣带皮质(PCC)之间的FC增加,海马体,小脑疣叶IV和V,和丘脑结构(后和外侧髓,中臭核,和腹侧外侧核)。此外,PAG和VPL之间的FC降低,膝状的身体,丘脑的膜内核,DRN,RN,SN,在这个比较中观察到了前额叶皮质。
结论:PAG和右前脑岛之间的FC改变,VPL,DRN,RN,SN,小脑疣叶IV和V,额叶皮质,PCC与SCI的NP后遗症有关。此外,SCI与PAG和右后脑岛之间的FC降低独立相关,小脑小叶IV和V,和小脑疣叶III,IV,和V.
OBJECTIVE: Neuropathic pain (NP) is a debilitating condition following spinal cord injury (SCI). The role of periaqueductal gray (PAG) in NP development following SCI remains underexplored. Using resting-state functional MRI (rsfMRI), our study aimed to demonstrate the alterations in functional connectivity (FC) of PAG in NP following SCI.
METHODS: Ten SCI patients (SCI + NP, n = 7, and SCI - NP, n = 3), alongside 10 healthy controls (HCs), were enrolled. rsfMRI was conducted followed by seed-to-voxel analysis using PAG as the seed region and then group-based analysis comprising three groups (SCI + NP, SCI - NP, and HC). Age and gender were considered as confounding variables.
RESULTS: Compared to HCs, SCI + NP demonstrated decreased FC between PAG and right insula, right frontal orbital cortex, right pallidum, dorsal raphe nucleus (DRN), red nuclei (RN), substantia nigra (SN), and ventral posterolateral (VPL) thalamic nuclei. Compared to SCI - NP, SCI + NP demonstrated increased FC between PAG and posterior cingulate cortex (PCC), hippocampus, cerebellar vermis lobules IV and V, and thalamic structures (posterior and lateral pulvinar, the mediodorsal nuclei, and the ventral lateral nuclei). Additionally, decreased FC between the PAG and VPL, geniculate bodies, intralaminar nuclei of thalamus, DRN, RN, SN, and prefrontal cortex was observed in this comparison.
CONCLUSIONS: Altered FC between PAG and right anterior insula, VPL, DRN, RN, SN, cerebellar vermis lobules IV and V, frontal cortex, and PCC was associated with NP sequelae of SCI. Additionally, SCI was independently associated with decreased FC between PAG and right posterior insula, cerebellar lobules IV and V, and cerebellar vermis lobules III, IV, and V.