The Brain in Chronic CRPS Pain: Abnormal Gray-White Matter Interactions in Emotional and Autonomic Regions

被引：430

作者：

Geha, Paul Y. ^{[1
]}

Baliki, Marwan N. ^{[1
]}

Harden, R. Norman ^{[2
]}

Bauer, William R. ^{[6
]}

Parrish, Todd B. ^{[3
]}

Apkarian, A. Vania ^{[1
,4
,5
]}

机构：

[1] Northwestern Univ, Feinberg Sch Med, Dept Physiol, Chicago, IL 60611 USA

[2] Northwestern Univ, Feinberg Sch Med, Inst Rehabil, Chicago, IL 60611 USA

[3] Northwestern Univ, Feinberg Sch Med, Dept Radiol, Chicago, IL 60611 USA

[4] Northwestern Univ, Feinberg Sch Med, Dept Anesthesia, Chicago, IL 60611 USA

[5] Northwestern Univ, Feinberg Sch Med, Dept Surg, Chicago, IL 60611 USA

[6] Univ Toledo, Dept Neurosci, Toledo, OH 43614 USA

来源：

NEURON | 2008年 / 60卷 / 04期

基金：

美国国家卫生研究院;

关键词：

D O I：

10.1016/j.neuron.2008.08.022

中图分类号：

Q189 [神经科学];

学科分类号：

071006 [神经生物学];

摘要：

Chronic complex regional pain syndrome (CRPS) is a debilitating pain condition accompanied by autonomic abnormalities. We investigated gray matter morphometry and white matter anisotropy in CRPS patients and matched controls. Patients exhibited a disrupted relationship between white matter anisotropy and whole-brain gray matter volume; gray matter atrophy in a single cluster encompassing right insula, right ventromedial prefrontal cortex (VMPFC), and right nucleus accumbens; and a decrease in fractional anisotropy in the left cingulum-callosal bundle. Reorganization of white matter connectivity in these regions was characterized by branching pattern alterations, as well as increased (VMPFC to insula) and decreased (VMPFC to basal ganglion) connectivity. While regional atrophy differentially related to pain intensity and duration, the strength of connectivity between specific atrophied regions related to anxiety. These abnormalities encompass emotional, autonomic, and pain perception regions, implying that they likely play a critical role in the global clinical picture of CRPS.

引用

页码：570 / 581

页数：12

共 79 条

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