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Brain Functional Alternations of the Pain-related Emotional and Cognitive Regions in Patients with Chronic Shoulder Pain

Authors Li JL, Yan CQ, Wang X, Zhang S, Zhang N, Hu SQ, Wang LQ, Liu CZ

Received 21 June 2019

Accepted for publication 7 March 2020

Published 20 March 2020 Volume 2020:13 Pages 575—583


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr E Alfonso Romero-Sandoval

Jin-Ling Li,1,2 Chao-Qun Yan,1 Xu Wang,3 Shuai Zhang,4 Na Zhang,5 Shang-Qing Hu,1 Li-Qiong Wang,1 Cun-Zhi Liu1

1School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 2Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 3School of Life Sciences, Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 4Department of Acupuncture and Moxibustion, Wangjing Hospital, Beijing, People’s Republic of China; 5School of Acupuncture and Moxibustion, Shandong University of Chinese Medicine, Shandong, People’s Republic of China

Correspondence: Cun-Zhi Liu
School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine, 11 Bei San Huan Dong Lu, Chaoyang District, Beijing 100029, People’s Republic of China
Tel +86 15901261692

Objective: Chronic shoulder pain (CSP) is a common health problem associated with shoulder dysfunction and persistent pain for many different reasons. However, the studies of pain-related functional brain regions in CSP have been poorly investigated. The main purpose of our study was to observe whether there are abnormal functional changes in brain regions in patients with CSP by using functional magnetic resonance imaging (fMRI).
Patients and Methods: We compared the differences of brain regions between 37 patients with CSP and 24 healthy controls (HC) using regional homogeneity (ReHo) method. The patients with chronic shoulder pain and healthy controls were matched for age and gender. Brain regions which had abnormal ReHo values were defined as seed region of interests. The approach of seed-based functional connectivity (FC) was further performed to analyze the connectivity between the seeds and whole brain regions. The relationship between abnormal regions and current clinical pain was also evaluated.
Results: Compared to healthy controls, the patients with CSP showed increased ReHo values in the left middle temporal gyrus and decreased ReHo values in right orbitofrontal cortex (OFC). The seed-based analyses demonstrated decreased connectivity between the right OFC and right rectus, superior frontal gyrus in patients with chronic shoulder pain. However, a correlation between ReHo values and clinical characteristics in CSP patients was not found.
Conclusion: The observed results indicate that there are abnormal ReHo values in brain regions of patients with CSP, especially in the OFC and middle temporal gyrus. Our findings demonstrate that the experience of CSP patients may be mainly associated with cognitive-affective pain processing, rather than nociception.

Keywords: functional magnetic resonance imaging, chronic shoulder pain, cognition, emotion

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