Distinct aberrations in cerebral pain processing differentiating patients with fibromyalgia from patients with rheumatoid arthritis

被引：17

作者：

Sandstrom, Angelica ^{[1
,2
]}

Ellerbrock, Isabel ^{[1
,2
]}

Lofgren, Monika ^{[3
]}

Altawil, Reem ^{[4
]}

Bileviciute-Ljungar, Indre ^{[3
]}

Lampa, Jon ^{[4
]}

Kosek, Eva ^{[1
,2
,5
]}

机构：

[1] Karolinska Inst, Dept Clin Neurosci, Nobels Vag 9, S-17177 Stockholm, Sweden

[2] Karolinska Univ Hosp, Dept Neuroradiol, Stockholm, Sweden

[3] Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Stockholm, Sweden

[4] Karolinska Inst, Ctr Mol Med CMM, Karolinska Univ Hosp, Dept Med, Stockholm, Sweden

[5] Uppsala Univ, Dept Surg Sci Pain Res, Uppsala, Sweden

来源：

PAIN | 2022年 / 163卷 / 03期

基金：

瑞典研究理事会;

关键词：

Functional magnetic resonance imaging (fMRI); Rheumatoid arthritis; Fibromyalgia; Cerebral pain processing; Functional connectivity; Inferior parietal lobe; Frontoparietal network; Sensorimotor network; SOMATOSENSORY PERCEPTION; EXERCISE; CONNECTIVITY; INFLAMMATION; STIMULATION;

D O I：

10.1097/j.pain.0000000000002387

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

The current study used functional magnetic resonance imaging to directly compare disease-relevant cerebral pain processing in well-characterized patient cohorts of fibromyalgia (FM, nociplastic pain) and rheumatoid arthritis (RA, nociceptive pain). Secondary aims were to identify pain-related cerebral alterations related to the severity of clinical symptoms such as pain intensity, depression, and anxiety. Twenty-six patients with FM (without RA-comorbidity) and 31 patients with RA (without FM-comorbidity) underwent functional magnetic resonance imaging while stimulated with subjectively calibrated painful pressures corresponding to a pain sensation of 50 mm on a 100-mm visual analogue scale. Stimulation sites were at the most inflamed proximal interphalangeal joint in the left hand in patients with RA and the left thumbnail in patients with FM, 2 sites that have previously been shown to yield the same brain activation in healthy controls. The current results revealed disease-distinct differences during pain modulation in RA and FM. Specifically, in response to painful stimulation, patients with FM compared to patients with RA exhibited increased brain activation in bilateral inferior parietal lobe (IPL), left inferior frontal gyrus (IFG)/ventrolateral prefrontal cortex (vlPFC) encapsulating left dorsolateral prefrontal cortex, and right IFG/vlPFC. However, patients with RA compared to patients with FM exhibited increased functional connectivity (during painful stimulation) between right and left IPL and sensorimotor network and between left IPL and frontoparietal network. Within the FM group only, anxiety scores positively correlated with pain-related brain activation in left dorsolateral prefrontal cortex and right IFG/vlPFC, which further highlights the complex interaction between affective (ie, anxiety scores) and sensory (ie, cerebral pain processing) dimensions in this patient group.

引用

页码：538 / 547

页数：10

共 53 条

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