Abstract
Cervical discogenic pain (CDP) is mainly induced by cervical disc degeneration. However, how CDP modulates the functional interactions within the pain network remains unclear. In the current study, we studied the changed resting-state functional connectivities of pain network with 40 CDP patients and 40 age-, gender-matched healthy controls. We first defined the pain network with the seeds of the posterior insula (PI). Then, whole brain and seed-to-target functional connectivity analyses were performed to identify the differences in functional connectivity between CDP and healthy controls. Finally, correlation analyses were applied to reveal the associations between functional connectivities and clinical measures. Whole-brain functional connectivity analyses of PI identified increased functional connectivity between PI and thalamus (THA) and decreased functional connectivity between PI and middle cingulate cortex (MCC) in CDP patients. Functional connectivity analyses within the pain network further revealed increased functional connectivities between bilateral PI and bilateral THA, and decreased functional connectivities between left PI and MCC, between left postcentral gyrus (PoCG) and MCC in CDP patients. Moreover, we found that the functional connectivities between right PI and left THA, between left PoCG and MCC were negatively and positively correlated with the visual analog scale, respectively. Our findings provide direct evidence of how CDP modulates the pain network, which may facilitate understanding of the neural basis of CDP.
Highlights
Cervical discogenic pain (CDP) is a chronic pain with clinical manifestations of pain in the head, neck, shoulder, and upper limbs, as well as pain associated with numbness
The pain intensity was assessed with the visual analog scale (VAS) test, cognitive functions were assessed with the Montreal cognitive assessment scale (MoCA), and emotional states were assessed using the Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA)
Decreased MoCA (p < 0.001) and significantly increased HAMD (p < 0.001), HAMA (p < 0.001) scores in CDP patients compared to healthy controls were found (Table 1)
Summary
Cervical discogenic pain (CDP) is a chronic pain with clinical manifestations of pain in the head, neck, shoulder, and upper limbs, as well as pain associated with numbness. CDP is a common source of neck pain with a reported prevalence between 16% and 41% (Peng and DePalma, 2018). Cervical discs have an amount of nerve fibers that are prone to structural disruption and inflammatory reactions that make them susceptible to pain. Long-term CDP leads to functional abnormalities in sensorimotor processing, emotion, cognition, and memory. Abnormal Pain Network in CDP (Montero-Homs, 2009; Linton, 2013; Denkinger et al, 2014). Despite such high prevalence, the neuropathology of CDP is still unclear
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