带状疱疹后神经痛患者杏仁核的功能连接改变研究

带状疱疹后神经痛(postherpetic neuralgia,PHN)是一种常见的神经病理性疼痛,但其中枢机制尚不明了.杏仁核在疼痛反应中的作用近年来受到关注.本研究的目的在于通过功能磁共振成像,研究带状疱疹后神经痛患者杏仁核各个亚区功能连接(functional connectivity,FC)的改变,探索慢性神经病理性疼痛的中枢机制.8位带状疱疹后神经痛患者和8位健康者进行了普通核磁共振和静息态功能磁共振扫描.将杏仁核各个亚区分别进行的功能连接分析,并将功能连接和被试者的病程、视觉模拟评分(visual analog scale,VAS)进行了相关分析.与健康志愿者相比,PHN患者杏仁核的基底外侧部(laterobasal groups,LB)和皮质部(superficial groups,SF)与多个脑区的FC表现出增强,主要位于颞叶和额叶.同时SF与多个区域的FC出现减低,主要位于额叶和顶叶.颞叶和额叶部分区域与LB的FC强度、与病程长短和VAS评分表现出关联性.研究结果提示,PHN患者杏仁核功能连接的改变提示了在慢性神经病理性疼痛的产生和发展中,杏仁核以及多个涉及情绪、认知、注意的脑区发挥了重要作用.

Altered Functional Connectivity of The Amygdala in Postherpetic Neuralgia

Postherpetic neuralgia (PHN) is a common type of neuropathic pain, the central mechanism of which is still unclear. The amygdala has recently garnered increased attention in pain processing. The purpose of this study is to investigate the functional neural networks of the amygdala in PHN and explore the mechanism of chronic neuropathic pain. Conventional magnetic resonance imaging (MRI) and resting-state functional MRI (fMRI) were performed in eight PHN patients and eight healthy controls. The functional connectivity (FC) of each subregion of the amygdala with the whole brain was computed. Paired t tests of the FC data were performed between the two experimental groups. Correlation analysis was applied between disease duration, visual analog scale (VAS), and FC strength. We found increased FC between the laterobasal (LB) and superficial (SF) amygdala and several brain regions including the temporal lobe and frontal lobe. We observed decreased FC between the SF amygdala and the precentral cortex, as well as the SF amygdala and parietal lobe. Correlation analysis showed that FC strength of the LB amygdala with both the temporal lobe and frontal lobe changed with disease duration and VAS in PHN patients. This altered FC in PHN suggests that the amygdala and several other brain regions involved in emotion, recognition, and attention play an important role in the modulation of chronic neuropathic pain.