The Brain FMRI Study Of Drug-naive Parkinson’s Disease Induced By Contact Heat Stimulations

Objective: Used functional magnetic resonance imaging (fMRI)techniques, observed brain regions activated to51℃contact thermal painstimulus (CHS) in drug-naive patients with Parkinson disease (PD),Compared brain function changes in drug-naive PD patients with in sex,age-matched controls about to explore pain related brain networks in the PDpatients.Methods:17patients with diagnosis of idiopathic PD group (PD) werecollected in the neurology department outpatient and the inpatient of northsichuan medical college affiliated hospital and19normal controls (controlgroup) were recruited by posters. During fMRI scans, the right dorsal forearm received51℃CHS.Two groups of fMRI data sets were obtained for eachsubject. Visual analogue scale (VAS) was used to evaluate the strength oftemperature stimulation for each subject after test. The quantitative senseorytest(QST) was used to assess thermal sensation (WS) and thermal painthreshold (HP). The fMRI data was analyzed using spm8software package..The brain activation of group was obtained by using one sample t test for thePD group and control group separately. The difference between PD group andcontrol group was analyzed by paired-sample t-test.Result:1. VAS score comparisonThe score of VAS in PD group was lower than control group withstatistical significance (P <0.01). 2. QST score comparison①WS comparison: WS threshold of PD group was significantly higherthan control group (P <0.05);②HP comparison: No difference was found inHP threshold between two groups（P＞0.05).3. Activated brain regions of CHS①These activated brain areas in control group with statisticalsignificance (P <0.005) included bilateral supplementary motor area(SMA)，bilateral anterior central gyrus，bilateral posterior central gyrus，bilateralsuperior temporal gyrus(STG)，ipsilateral middle temporal gyrus(MTG)，bilateral central sulcus，bilateral middle cingulate cortex(MCC)，bilateralinsula，bilateral supramarginal gyrus，bilateral transverse temporal gyrus，bilateral inferior frontal gyrus(IFG)，ipsilateral superior frontal gyrus(SFG)，bilateral Putamen， bilateral precuneus， ipsilateral paracentral lobule，contralateral cerebellum，contralateral parahippocampal gyrus.②These activated brain areas in PD group with statistical significance (P<0.005) included bilateral central sulcus，bilateral supramarginal gyrus，bilateral STG，bilateral MTG，bilateral anterior central gyrus，bilateralposterior central gyrus， bilateral insula,bilateral thalamus,bilateralhippocampus，bilateral MCC，bilateral SMA，ipsilateral SFG，ipsilateralsuperior parietal lobule，ipsilateral precuneus，ipsilateral paracentral lobule，contralateral candate nucleus，bilateral inferior parietal lobule.③Compared with control group, the brain areas of PD group whichactivated stronger included contralateral parahippocampal cortex， bilateralprecuneus，ipsilateral posterior central gyrus，bilateral hippocampus，bilateral cerebellum，the weaker brain areas is that bilateral STG，ipsilateral SMA，ipsilateral anterior central gyrus，ipsilateral posterior central gyrus，ipsilateralSFG(P＜0.005).Conclusions:1.Combination of CHS-MRI can applied to investigate the Pain relatedbrain networks.Multiple brain regions activated by contact heat stimulationssignificantly supported that the pain was associated with multiple brainregions which were included in pain-related brain networks.2. Activated brain regions of two groups had different in position andintensity. Compared with control group，the WS threshold of QST washigher and the score of VAS was lower in patients with PD, and Pain relatedbrain networks of PD group may also change.