Abstract
Myofascial pain, presented as myofascial trigger points (MTrPs)-related pain, is a common, chronic disease involving skeletal muscle, but its underlying mechanisms have been poorly understood. Previous studies have revealed that chronic pain can induce microstructural abnormalities in the cerebral gray matter. However, it remains unclear whether the brain gray matters of patients with chronic MTrPs-related pain undergo alteration. In this study, we employed the Diffusion Kurtosis Imaging (DKI) technique, which is particularly sensitive to brain microstructural perturbation, to monitor the MTrPs-related microstructural alterations in brain gray matter of patients with chronic pain. Our results revealed that, in comparison with the healthy controls, patients with chronic myofascial pain exhibited microstructural abnormalities in the cerebral gray matter and these lesions were mainly distributed in the limbic system and the brain areas involved in the pain matrix. In addition, we showed that microstructural abnormalities in the right anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC) had a significant negative correlation with the course of disease and pain intensity. The results of this study demonstrated for the first time that there are microstructural abnormalities in the brain gray matter of patients with MTrPs-related chronic pain. Our findings may provide new insights into the future development of appropriate therapeutic strategies to this disease.
Highlights
Myofascial pain syndrome is a common type of chronic pain involving the skeletal muscles and is characterized by the presence of myofascial trigger points (MTrPs)
There were no significant differences in age and gender between the MTrPs subjects
Our results revealed that the microstructural alterations in the brain resulting from chronic myofascial pain are not limited to a single pain center; instead, these alterations are widely disseminated in the cerebral cortex
Summary
Myofascial pain syndrome is a common type of chronic pain involving the skeletal muscles and is characterized by the presence of myofascial trigger points (MTrPs). MTrPs are clinically defined as highly localized and cord-shaped sensitive areas in the skeletal muscle that have tension and can be palpated. Stretching, pressing, or contraction of the skeletal muscles may trigger characteristic pain, which is often accompanied by referred pain. MTrPs can be classified into active MTrPs and latent MTrPs. Active MTrPs induce spontaneous pain or motion-induced reactive pain, while. Chronic Myofascial Pain latent MTrPs induce pain or discomfort only when pressed (Simons, 2008; Xie et al, 2015). MTrPs-related myofascial pain has a prevalence of 21–30% in the general population (Borg-Stein and Iaccarino, 2014). In the United States, over 44 million individuals have developed this disease and collectively require 47 billion dollars in medical expenditures every year (Wheeler, 2004)
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