sensorimotor network

感觉运动网络
  • 文章类型: Journal Article
    背景:儿童创伤与成人抑郁症密切相关,但神经生物学机制仍不清楚。先前的研究表明,抑郁症与大型大脑网络之间存在关联,例如腹侧注意力网络(VAN)和体感运动网络(SMN)。这项研究假设这些网络内部和之间的功能连接(FC)介导了儿童创伤与成人抑郁症之间的联系。
    方法:儿童创伤问卷(CTQ)评估发育经历,和汉密尔顿抑郁量表(HAMD-17)衡量抑郁症状。静息状态功能磁共振成像(fMRI)分析了VAN和SMN内部和之间的FC。
    结果:抑郁组表现出更高的HAMD和CTQ评分,以及VAN内以及VAN和SMN之间的FC升高(P<0.05)。HAMD总分与VAN内FC呈正相关(P<0.05,r=0.35),VAN与SMN呈正相关(P<0.05,r=0.34),以及CTQ总分(P<0.05,r=0.27)。CTQ总分与VAN内FC呈正相关(P<0.05,r=0.31),VAN与SMN呈正相关(P<0.05,r=0.29)。在调解模式中,FC内和之间的VAN和SMN显著介导了儿童期创伤和抑郁。
    结论:横截面设计限制了因果推断。不同创伤类型的样本量相对较小,敦促在推广调查结果时保持谨慎。
    结论:该研究强调了抑郁症严重程度之间的关联,VAN功能障碍,异常的VAN-SMNFC,童年的创伤。这些发现有助于理解童年创伤和抑郁症的神经生物学机制。
    BACKGROUND: Childhood trauma is closely tied to adult depression, but the neurobiological mechanisms remain unclear. Previous studies suggested associations between depression and large-scale brain networks such as the Ventral Attention Network (VAN) and Somatosensory Motor Network (SMN). This study hypothesized that functional connectivity (FC) within and between these networks mediates the link between childhood trauma and adult depression.
    METHODS: The Childhood Trauma Questionnaire (CTQ) assessed developmental experiences, and the Hamilton Rating Scale for Depression (HAMD-17) gauged depressive symptoms. Resting-state functional magnetic resonance imaging (fMRI) analyzed FC within and between the VAN and SMN.
    RESULTS: Depression group exhibited significantly higher HAMD and CTQ scores, as well as elevated FC within the VAN and between the VAN and SMN (P < 0.05). Positive correlations were found between HAMD total score and FC within the VAN (P < 0.05, r = 0.35) and between the VAN and SMN (P < 0.05, r = 0.34), as well as with CTQ total score (P < 0.05, r = 0.27). Positive correlations were also observed between CTQ total score and FC within the VAN (P < 0.05, r = 0.31) and between the VAN and SMN (P < 0.05, r = 0.29). In the mediation model, FC within and between the VAN and SMN significantly mediated childhood trauma and depression.
    CONCLUSIONS: The cross-sectional design limits causal inference. The sample size for different trauma types is relatively small, urging caution in generalizing findings.
    CONCLUSIONS: The study underscores the association between depression severity, VAN dysfunction, abnormal VAN-SMN FC, and childhood trauma. These findings contribute to understanding the neurobiological mechanisms underlying childhood trauma and depression.
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  • 文章类型: Journal Article
    多发性硬化症(MS)的运动疲劳是由于运动皮层(M1)输出减少和感觉运动网络(SMN)调制改变所致。那他珠单抗,一种疾病改善疗法,减少神经炎症和改善疲劳。然而,部分接受那他珠单抗治疗的患者在后续输注前出现疲劳复发(\'逐渐消失\').磨损提供了一个有价值的窗口,进入MS相关的运动疲劳机制,临床稳定,设置。这项研究调查了磨损是否与运动疲劳恶化及其神经生理机制相关,并评估了那他珠单抗对MS相关疲劳的影响。在那他珠单抗输注前后,对45例复发缓解型MS患者进行了评估。评估包括评估残疾水平,抑郁症状,以及疲劳症状对认知的影响,物理,和心理社会功能。运动疲劳指数是通过疲劳任务和外围设备完成的块数来计算的,中央,通过测量周围神经诱发的叠加抽搐和M1的经颅磁刺激来评估脊柱上疲劳(M1输出)。经颅磁刺激脑电图通过测量任务前后SMN内的TMS诱发电位(TEP)来评估M1的有效连通性。我们发现磨损与运动疲劳指数增加有关,增加的中央和脊柱上疲劳,与那他珠单抗输注后相比,TEP的任务相关调节减弱。磨损也与疲劳影响和抑郁症状评分恶化有关。我们得出的结论是,由于M1输出和SMN调制的改变,磨损现象与运动疲劳恶化有关。MS中的运动疲劳可能反映出可逆的,那他珠单抗可以调节的SMN的炎症相关变化。我们的发现主要适用于接受那他珠单抗的MS患者,强调需要进一步研究其他治疗方法。
    Motor fatigue in Multiple Sclerosis (MS) is due to reduced motor cortex (M1) output and altered sensorimotor network (SMN) modulation. Natalizumab, a disease-modifying therapy, reduces neuroinflammation and improves fatigue. However, some patients treated with natalizumab experience fatigue recurrence (\'wearing-off\') before subsequent infusions. Wearing-off provides a valuable window into MS-related motor fatigue mechanisms in a controlled, clinically stable, setting. This study investigates whether wearing-off is associated with worsening motor fatigue and its neurophysiological mechanisms and assesses natalizumab\'s effect on MS-related fatigue. Forty-five relapsing-remitting MS patients with wearing-off symptoms were evaluated pre- and post-natalizumab infusion. Assessments included evaluating disability levels, depressive symptoms, and the impact of fatigue symptoms on cognitive, physical, and psychosocial functioning. The motor fatigue index was computed through the number of blocks completed during a fatiguing task and peripheral, central, and supraspinal fatigue (M1 output) were evaluated by measuring the superimposed twitches evoked by peripheral nerve and transcranial magnetic stimulation of M1. Transcranial magnetic stimulation-electroencephalography assessed M1 effective connectivity by measuring TMS-evoked potentials (TEPs) within the SMN before- and after the task. We found that wearing-off was associated with increased motor fatigue index, increased central and supraspinal fatigue, and diminished task-related modulation of TEPs compared to post-natalizumab infusion. Wearing-off was also associated with worsened fatigue impact and depression symptom scores. We conclude that the wearing-off phenomenon is associated with worsening motor fatigue due to altered M1 output and modulation of the SMN. Motor fatigue in MS may reflect reversible, inflammation-related changes in the SMN that natalizumab can modulate. Our findings apply primarily to MS patients receiving natalizumab, emphasizing the need for further research on other treatments with wearing-off.
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  • 文章类型: Journal Article
    小脑-脑功能连接(CC-FC)在强迫症(OCD)中的作用,药物治疗后的轨迹,其作为预后生物标志物和遗传机制的潜力仍不确定。为了弥补这些差距,这项研究包括37例未接受药物治疗的强迫症患者和37例健康对照(HCs).参与者接受基线功能磁共振成像(fMRI),随后帕罗西汀治疗强迫症患者四周,和另一个fMRI扫描治疗后。我们检查了患者和HC之间基于种子的CC-FC差异,以及治疗前和治疗后的患者。基于CC-FC进行支持向量回归(SVR)以预测治疗反应。相关分析探讨CC-FC与临床特征之间的关联,以及基因图谱。与HC相比,未服用药物的强迫症患者在执行中表现出降低的CC-FC,情感边缘,和感觉运动网络,具有与改变的CC-FC相关的特定遗传特征。基因富集分析强调了这些基因参与各种生物过程,分子功能,和路径。后处理,患者表现出部分临床改善和部分恢复先前降低的CC-FC.基线CC-FC异常与强迫严重程度和社会功能损害呈负相关,而CC-FC的变化与治疗后的认知功能变化相关。CC-FC是帕罗西汀治疗后患者症状严重程度的潜在预测因子。这项纵向静息状态fMRI研究强调了CC-FC在OCD的神经心理学机制及其药物治疗中的关键作用。转录组-神经成像空间相关性分析提供了对OCD病理学基础的神经生物学机制的见解。此外,SVR分析有望促进治疗强迫症患者的精准医学方法。
    The role of cerebellar-cerebral functional connectivity (CC-FC) in obsessive-compulsive disorder (OCD), its trajectory post-pharmacotherapy, and its potential as a prognostic biomarker and genetic mechanism remain uncertain. To address these gaps, this study included 37 drug-naive OCD patients and 37 healthy controls (HCs). Participants underwent baseline functional magnetic resonance imaging (fMRI), followed by four weeks of paroxetine treatment for patients with OCD, and another fMRI scan post-treatment. We examined seed-based CC-FC differences between the patients and HCs, and pre- and post-treatment patients. Support vector regression (SVR) based on CC-FC was performed to predict treatment response. Correlation analysis explored associations between CC-FC and clinical features, as well as gene profiles. Compared to HCs, drug-naive OCD patients exhibited reduced CC-FC in executive, affective-limbic, and sensorimotor networks, with specific genetic profiles associated with altered CC-FC. Gene enrichment analyses highlighted the involvement of these genes in various biological processes, molecular functions, and pathways. Post-treatment, the patients showed partial clinical improvement and partial restoration of the previously decreased CC-FC. Abnormal CC-FC at baseline correlated negatively with compulsions severity and social functional impairment, while changes in CC-FC correlated with cognitive function changes post-treatment. CC-FC emerged as a potential predictor of symptom severity in patients following paroxetine treatment. This longitudinal resting-state fMRI study underscores the crucial role of CC-FC in the neuropsychological mechanisms of OCD and its pharmacological treatment. Transcriptome-neuroimaging spatial correlation analyses provide insight into the neurobiological mechanisms underlying OCD pathology. Furthermore, SVR analyses hold promise for advancing precision medicine approaches in treating patients with OCD.
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  • 文章类型: Journal Article
    物质使用障碍(SUDs)是严重的精神疾病。种子区域和独立成分分析目前是主要的连通性措施,但由于选择而存在假阴性的风险。它们可以通过数据驱动和全脑使用体素固有测量(VIM)来补充。我们在元分析上整合了VIM,即区域同质性(ReHo),低频波动幅度(ALFF),使用激活似然估计(ALE)算法,跨不同SUD的体素镜像同伦连通性(VMHC)和度中心性(DC),功能解码的新兴集群,并分析了它们的连通性概况。我们的系统搜索确定了51项研究,包括1439名SUD参与者。尽管在SUD中没有发现跨VIM的整体趋同变化模式,敏感性分析表明,SUD中ReHo和ALFF增加的两个ALE衍生簇,在左中央前后皮质达到顶峰。随后的分析表明他们参与了行动执行,Somesthesis,手指敲击和振动触觉监测/辨别。他们在纳入的研究中的众多临床相关性突出了感觉运动皮质在SUD中的作用,敦促更仔细地探索它们的临床意义。
    Substance use disorders (SUDs) are severe psychiatric illnesses. Seed region and independent component analyses are currently the dominant connectivity measures but carry the risk of false negatives due to selection. They can be complemented by a data-driven and whole-brain usage of voxel-wise intrinsic measures (VIMs). We meta-analytically integrated VIMs, namely regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF), voxel-mirrored homotopy connectivity (VMHC) and degree centrality (DC) across different SUDs using the Activation Likelihood Estimation (ALE) algorithm, functionally decoded emerging clusters, and analysed their connectivity profiles. Our systematic search identified 51 studies including 1439 SUD participants. Although no overall convergent pattern of alterations across VIMs in SUDs was found, sensitivity analyses demonstrated two ALE-derived clusters of increased ReHo and ALFF in SUDs, which peaked in the left pre- and postcentral cortices. Subsequent analyses showed their involvement in action execution, somesthesis, finger tapping and vibrotactile monitoring/discrimination. Their numerous clinical correlates across included studies highlight the under-discussed role of sensorimotor cortices in SUD, urging a more attentive exploration of their clinical significance.
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  • 文章类型: Journal Article
    背景:多发性硬化症(pwMS)患者的运动准备和执行可能受损。可以使用脑电图(EEG)评估这些神经过程。在一个自定节奏的运动中,EEG信号幅度在运动之前减小(事件相关的去同步,ERD)并在移动后增加(与事件相关的同步,ERS).
    目的:与健康对照组(HC)相比,重新评估pwMS中ERD/ERS的变化。
    方法:这项单中心研究包括13个pwMS和10个性别/年龄匹配的HC。在右手的两个自步调运动中记录了60通道的EEG:简单的食指伸展任务和更复杂的手指敲击任务。临床变量包括MS类型,性别,年龄,疾病持续时间,残疾,握力,疲劳和注意力表现。EEG变量包括ERD和ERS发作潜伏期,持续时间,和使用两种信号分析方法(基于视觉或自动确定)在五个皮质区域的α和β频带中确定的幅度:左右额中央和中心顶叶区域以及中线区域。神经影像学变量包括四个深部大脑结构的体积(丘脑,壳核,苍白球和尾状核)和相对病变负荷。
    结果:仅在β带中观察到与HC相比,pwMS中的ERD/ERS变化。在pwMS中,β-ERD在中线和右侧顶中央区域延迟发作,在顶中央区域持续时间缩短或振幅增加;β-ERD持续时间较短,延迟发作,或在左侧顶/额中央区域的振幅减小。此外,在中线区域具有更延迟的β-ERD的pwMS的执行功能受损较少,但尾状核体积增加,而在运动对侧的顶中央区域具有更延迟的β-ERS的pwMS疲劳较少,但丘脑体积增加。
    结论:这项研究证实了pwMS中运动准备和执行的改变,主要特征是β带中的皮质激活延迟(ERD)和运动后抑制(ERS)延迟和减少。这些变化可能涉及补偿机制,将更多保留的临床表现和大脑深部结构的过度激活相关联。
    BACKGROUND: Motor preparation and execution can be impaired in patients with multiple sclerosis (pwMS). These neural processes can be assessed using electroencephalography (EEG). During a self-paced movement, EEG signal amplitude decreases before movement (event-related desynchronization, ERD) and increases after movement (event-related synchronization, ERS).
    OBJECTIVE: To reappraise ERD/ERS changes in pwMS compared to healthy controls (HC).
    METHODS: This single-center study included 13 pwMS and 10 sex/age-matched HC. 60-channel EEG was recorded during two self-paced movements of the right hand: a simple index finger extension task and a more complex finger tapping task. Clinical variables included MS type, sex, age, disease duration, disability, grip strength, fatigue and attentional performance. EEG variables included ERD and ERS onset latency, duration, and amplitude determined using two methods of signal analyses (based on visual or automated determination) in the alpha and beta frequency bands in five cortical regions: right and left frontocentral and centroparietal regions and a midline region. Neuroimaging variables included the volumes of four deep brain structures (thalamus, putamen, pallidum and caudate nucleus) and the relative lesion load.
    RESULTS: ERD/ERS changes in pwMS compared to HC were observed only in the beta band. In pwMS, beta-ERD had a delayed onset in the midline and right parietocentral regions and a shortened duration or increased amplitude in the parietocentral region; beta-ERS had a shorter duration, delayed onset, or reduced amplitude in the left parieto/frontocentral region. In addition, pwMS with a more delayed beta-ERD in the midline region had less impaired executive functions but increased caudate nuclei volume, while pwMS with a more delayed beta-ERS in the parietocentral region contralateral to the movement had less fatigue but increased thalami volume.
    CONCLUSIONS: This study confirms an alteration of movement preparation and execution in pwMS, mainly characterized by a delayed cortical activation (ERD) and a delayed and reduced post-movement inhibition (ERS) in the beta band. Compensatory mechanisms could be involved in these changes, associating more preserved clinical performance and overactivation of deep brain structures.
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  • 文章类型: Journal Article
    运动想象疗法(MIT)对上肢运动功能具有积极作用。然而,MIT改善上肢运动功能的机制尚不完全清楚。因此,我们的目的是研究MIT引起的与脑卒中患者上肢运动功能改善相关的感觉运动网络(SMN)内外功能连接(FC)的变化.
    将26例脑卒中偏瘫患者随机分为MIT组(n=13)和对照组(n=13)。Fugl-Meyer评估上肢量表(FMA-UL),两组治疗前及治疗4周后进行改良Barthel指数(MBI)及静息态功能磁共振成像(rs-fMRI)评价。比较两组治疗前后FMA-UL和MBI评分,评价MIT对脑卒中偏瘫患者运动功能改善的疗效。此外,对脑卒中患者不同治疗方法前后的SMN内以及SMN与全脑之间的FC进行测量和比较。检查了上肢运动功能的改善与SMN内以及SMN与全脑之间的FC变化之间的相关性分析。
    同病初级运动皮层之间的FCs(M1。I)和对侧辅助运动区(SMA。C),I和同质SMA(SMA。I),和SMA。C和对侧背外侧运动前皮质(DLPM。C)在对照组显著升高,但在MIT组降低;而SMA之间的FC。C和对侧初级体感皮层(S1。C)在对照组中显着增加,但在MIT组中没有显着差异。M1之间的FC。I和同侧海马回和同侧额中回在对照组中显着降低,但在MIT组中增加;而MIT组对侧前扣带皮质的FC显着增加,但与对照组无显着差异。相关性分析结果显示,SMN内异常FCs的差异与FMA和MBI的差异呈负相关,SMN异常间FCs的差异与FMA和MBI的差异呈正相关。
    MIT可以改善中风患者的上肢运动功能和日常活动,常规康复治疗(CRT)联合MIT的改善效果明显高于单纯CRT。CRT可能主要通过SMN之间的功能重组来改善脑卒中偏瘫患者的上肢运动功能,而MIT可能主要增加SMN与其他大脑网络之间的相互作用。
    UNASSIGNED: Motor imagery therapy (MIT) showed positive effects on upper limbs motor function. However, the mechanism by which MIT improves upper limb motor function is not fully understood. Therefore, our purpose was to investigate the changes in functional connectivity (FC) within and outside the sensorimotor network (SMN) induced by MIT associated with improvement in upper limb motor function in stroke patients.
    UNASSIGNED: A total of 26 hemiplegic stroke patients were randomly divided into MIT (n = 13) and control (n = 13) groups. Fugl-Meyer Assessment Upper Extremity Scale (FMA-UL), Modified Barthel Index (MBI) and resting-state functional magnetic resonance imaging (rs-fMRI) were evaluated in the two groups before treatment and 4 weeks after treatment. The efficacy of MIT on motor function improvement in stroke patients with hemiplegia was evaluated by comparing the FMA-UL and MBI scores before and after treatment in the two groups. Furthermore, the FC within the SMN and between the SMN and the whole brain was measured and compared before and after different treatment methods in stroke patients. The correlation analysis between the improvement of upper limbs motor function and changes in FC within the SMN and between the SMN and the whole brain was examined.
    UNASSIGNED: The FCs between ipsilesional primary motor cortex (M1.I) and contralateral supplementary motor area (SMA.C), M1.I and ipsilesional SMA (SMA.I), and SMA.C and contralateral dorsolateral premotor cortex (DLPM.C) significantly increased in the control group but decreased in the MIT group; while the FC between SMA.C and contralateral primary somatosensory cortex (S1.C) significantly increased in the control group but showed no significant difference in the MIT group. The FCs between M1.I and the ipsilesional hippocampal gyrus and ipsilesional middle frontal gyrus significantly decreased in the control group but increased in the MIT group; while the FC in the contralateral anterior cingulate cortex significantly increased in the MIT group but there was no significant difference in the control group. The results of the correlation analysis showed that the differences in abnormal intra-FCs within the SMN negatively correlated with the differences in FMA and MBI, and the difference in abnormal inter-FCs of the SMN positively correlated with the differences in FMA and MBI.
    UNASSIGNED: MIT can improve upper limb motor function and daily activities of stroke patients, and the improvement effect of conventional rehabilitation therapy (CRT) combined with MIT is significantly higher than that of CRT alone. CRT may improve the upper limb motor function of stroke patients with hemiplegia mainly through the functional reorganization between SMN, while MIT may mainly increase the interaction between SMN and other brain networks.
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  • 文章类型: Journal Article
    强迫症(OCD)药物治疗后体素镜像同源连接(VMHC)的轨迹及其在预测治疗反应中的价值尚不清楚。本研究旨在探讨强迫症的病理生理机制,以及预测药理疗效的生物标志物。无药物治疗的强迫症患者和健康对照(HCs)进行了磁共振成像。帕罗西汀治疗4周后再次扫描患者。对采集的数据进行VMHC,支持向量回归(SVR),和相关分析。与HCs(36名受试者)相比,强迫症患者(排除两名头部过度运动的受试者后的34名受试者)在双侧顶叶上小叶(SPL)中表现出明显较低的VMHC,中央后回,和钙的皮质,中央回的VMHC与认知功能呈正相关。治疗后,随着症状的改善,患者显示双侧扣带回后皮质/前突(PCC/PCu)中的VMHC增加。SVR结果表明,基线时中央回的VMHC可以帮助预测OCD量表评分的变化。这项研究表明,SPL,中央后回,钙卡碱皮质参与OCD的病理生理机制,PCC/PCu参与药理机制。中枢后回的VMHC是OCD治疗效果的潜在预测生物标志物。
    The trajectory of voxel-mirrored homotopic connectivity (VMHC) after medical treatment in obsessive-compulsive disorder (OCD) and its value in prediction of treatment response remains unclear. This study aimed to investigate the pathophysiological mechanism of OCD, as well as biomarkers for prediction of pharmacological efficacy. Medication-free patients with OCD and healthy controls (HCs) underwent magnetic resonance imaging. The patients were scanned again after a 4-week treatment with paroxetine. The acquired data were subjected to VMHC, support vector regression (SVR), and correlation analyses. Compared with HCs (36 subjects), patients with OCD (34 subjects after excluding two subjects with excessive head movement) exhibited significantly lower VMHC in the bilateral superior parietal lobule (SPL), postcentral gyrus, and calcarine cortex, and VMHC in the postcentral gyrus was positively correlated with cognitive function. After treatment, the patients showed increased VMHC in the bilateral posterior cingulate cortex/precuneus (PCC/PCu) with the improvement of symptoms. SVR results showed that VMHC in the postcentral gyrus at baseline could aid to predict a change in the scores of OCD scales. This study revealed that SPL, postcentral gyrus, and calcarine cortex participate in the pathophysiological mechanism of OCD while PCC/PCu participate in the pharmacological mechanism. VMHC in the postcentral gyrus is a potential predictive biomarker of the treatment effects in OCD.
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  • 文章类型: Journal Article
    背景:疲劳是肌能性脑脊髓炎或慢性疲劳综合征(ME/CFS)的主要特征,但许多ME/CFS患者也报告有共病疼痛症状.目前尚不清楚这些症状是否与相似或分离的大脑网络有关。这项研究使用静息状态功能磁共振成像来解开与ME/CFS患者的疲劳和疼痛症状相关的网络,并将这些网络的变化与认知行为疗法(CBT)后的临床改善联系起来。
    方法:在基线(N=72)和CBT(N=33)和等待列表(WL,N=18),并与健康对照(HC,N=29)。分析集中在以前与疼痛和/或疲劳相关的四个网络上,即额顶叶网络(FPN),电机前网络(PMN),躯体运动网络(SMN),和默认模式网络(DMN)。
    结果:在基线时,与部分分离的大脑网络相关的疼痛和疲劳症状的变化。疲劳与较高的SMN-PMN连通性和较低的SMN-DMN连通性相关。疼痛与较低的PMN-DMN连接相关。CBT改进了SMN-DMN连接,与WL相比。较大的临床改善与额叶SMN-DMN连通性的较大增加相关。对于PMN-DMN或SMN-PMN连接没有观察到CBT效应。
    结论:这些结果提供了对ME/CFS中疲劳和疼痛症状的可分离神经机制的了解,以及在成功治疗的患者中它们如何受到CBT的影响。有必要进一步研究行为和生物医学治疗如何以及谁影响这些网络,以改善和个性化ME/CFS的现有或新治疗方法。
    BACKGROUND: Fatigue is a central feature of myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS), but many ME/CFS patients also report comorbid pain symptoms. It remains unclear whether these symptoms are related to similar or dissociable brain networks. This study used resting-state fMRI to disentangle networks associated with fatigue and pain symptoms in ME/CFS patients, and to link changes in those networks to clinical improvements following cognitive behavioral therapy (CBT).
    METHODS: Relationships between pain and fatigue symptoms and cortico-cortical connectivity were assessed within ME/CFS patients at baseline (N = 72) and after CBT (N = 33) and waiting list (WL, N = 18) and compared to healthy controls (HC, N = 29). The analyses focused on four networks previously associated with pain and/or fatigue, i.e. the fronto-parietal network (FPN), premotor network (PMN), somatomotor network (SMN), and default mode network (DMN).
    RESULTS: At baseline, variation in pain and fatigue symptoms related to partially dissociable brain networks. Fatigue was associated with higher SMN-PMN connectivity and lower SMN-DMN connectivity. Pain was associated with lower PMN-DMN connectivity. CBT improved SMN-DMN connectivity, compared to WL. Larger clinical improvements were associated with larger increases in frontal SMN-DMN connectivity. No CBT effects were observed for PMN-DMN or SMN-PMN connectivity.
    CONCLUSIONS: These results provide insight into the dissociable neural mechanisms underlying fatigue and pain symptoms in ME/CFS and how they are affected by CBT in successfully treated patients. Further investigation of how and in whom behavioral and biomedical treatments affect these networks is warranted to improve and individualize existing or new treatments for ME/CFS.
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  • 文章类型: Journal Article
    原发性眼睑痉挛(BSP)是一种临床异质性疾病,不仅表现为眼睑的痉挛性闭合,有时还表现为眼睑张开(AEO)的失用症。这项横断面研究旨在调查孤立的BSP和BSP相关AEO亚型的神经机制的差异,这可能揭示了不同表型背后的病理生理学。
    共有29例患者表现为孤立性BSP,17例患者表现为与AEO相关的BSP,28名健康对照者接受了静息态功能近红外光谱(fNIRS)检测。我们评估了额顶叶控制网络(PFCN)和感觉运动网络(SMN)中感兴趣区域(ROI)之间的功能连通性(FC)。我们还检查了改变的FC和行为数据之间的关系。
    在FPCN中,ROI分析显示,与分离的BSP组相比,AEO组的BSP左前运动皮层和上脑回之间的FC降低。在SMN中,两个亚组都显示左运动前皮层与右初级运动皮层的连通性不足,初级感觉皮层,和体感联想皮层。这种低连通性与肉毒杆菌毒素A治疗的总数呈正相关,这表明长期的肉毒杆菌毒素A治疗可能会调节运动序列的规划和协调。
    这些研究结果表明,在BSP的不同行为表型中,与运动和认知控制相关的神经网络的连通性改变不同。在对应于临床异质性的各种网络中特定改变的鉴定可以告知用于早期诊断的潜在生物标志物的鉴定和用于治疗不同BSP亚表型的个性化神经调节靶标。
    UNASSIGNED: Primary blepharospasm (BSP) is a clinically heterogeneous disease that manifests not only as spasmodic closure of the eyelids but also sometimes with apraxia of eyelid opening (AEO). This cross-sectional study aimed to investigate differences in the neural mechanisms of isolated BSP and BSP-associated AEO subtypes, which may reveal the pathophysiology underlying different phenotypes.
    UNASSIGNED: A total of 29 patients manifested as isolated BSP, 17 patients manifested as BSP associated with AEO, and 28 healthy controls underwent resting-state functional near-infrared spectroscopy (fNIRS). We assessed functional connectivity (FC) between regions of interest (ROIs) in the fronto-parietal control network (PFCN) and sensorimotor network (SMN). We also examined the relationship between altered FC and behavioral data.
    UNASSIGNED: In the FPCN, ROI- analyses showed decreased FC between the left premotor cortex and supramarginal gyrus in the BSP with AEO group compared to the isolated BSP group. In the SMN, both subgroups showed hypoconnectivity of the left premotor cortex with the right primary motor cortex, primary sensory cortex, and somatosensory association cortex. This hypoconnectivity was positively correlated with the total number of botulinum toxin A treatments, which suggests that long-term botulinum toxin A treatment may modulate motor sequence planning and coordination.
    UNASSIGNED: These findings showed different connectivity alterations in neural networks associated with motor and cognitive control among different behavioral phenotypes of BSP. The identification of specific alterations in various networks that correspond to clinical heterogeneity may inform the identification of potential biomarkers for early diagnosis and personalized neuromodulation targets for treating different BSP subphenotypes.
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  • 文章类型: Journal Article
    在复杂区域疼痛综合征(CRPS)中,在感觉刺激和运动行为过程中,初级感觉运动皮层(SM1)患肢的代表区反应异常.我们记录了17名上肢CRPS1型患者和19名健康对照受试者的3T功能磁共振成像静息状态数据,以确定自发性疼痛期间患者SM1功能的变化,并了解这些变化的空间分布如何与周围症状相关。基于种子的相关性和独立成分分析表明,患者的上肢SM1代表区域显示(i)半球间连通性降低,与肢体疼痛的强度和空间范围的联合作用有关,(ii)与CRPS持续时间呈正相关的右前脑岛的连通性增加,(iii)与导水管周围灰质的连通性增加,以及(iv)与SM1网络的其他部分脱离。这些发现,现在CRPS首次报道,与患有其他慢性疼痛或肢体神经支配的患者的改变平行;他们也同意暴露于实验性疼痛或不对称使用四肢的健康人的发现。我们的结果表明,CRPS与SM1功能的持续和躯体特异性改变有关,与周围表现的空间分布和综合征的持续时间相对应。
    In complex regional pain syndrome (CRPS), the representation area of the affected limb in the primary sensorimotor cortex (SM1) reacts abnormally during sensory stimulation and motor actions. We recorded 3T functional magnetic resonance imaging resting-state data from 17 upper-limb CRPS type 1 patients and 19 healthy control subjects to identify alterations of patients\' SM1 function during spontaneous pain and to find out how the spatial distribution of these alterations were related to peripheral symptoms. Seed-based correlations and independent component analyses indicated that patients\' upper-limb SM1 representation areas display (i) reduced interhemispheric connectivity, associated with the combined effect of intensity and spatial extent of limb pain, (ii) increased connectivity with the right anterior insula that positively correlated with the duration of CRPS, (iii) increased connectivity with periaqueductal gray matter, and (iv) disengagement from the other parts of the SM1 network. These findings, now reported for the first time in CRPS, parallel the alterations found in patients suffering from other chronic pain conditions or from limb denervation; they also agree with findings in healthy persons who are exposed to experimental pain or have used their limbs asymmetrically. Our results suggest that CRPS is associated with a sustained and somatotopically specific alteration of SM1 function, that has correspondence to the spatial distribution of the peripheral manifestations and to the duration of the syndrome.
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