The Brain FMRI Study Of Patients With PD And Pain Induced By Contact Heat Stimulations

Objective:Using functional magnetic resonance imaging(fMRI)technology to observe the contact between patients with PD and pain(PDP)and patients with PD but no pain(nPDP)and healthy controls Imaging changes of brain function activation area under contact heat stimulation(CHS),exploring PDP pain related brain network,in order to provide valuable information for clinical classification and treatment of PD.Methods:Collect 11 cases of PDP(PDP group)and 15 cases of nPDP(nPDP group),recruit 17 healthy adults of gender and age matching as the control group;all subjects were evaluated by clinical scale,arid then on the right forearm dorsal Line 51℃ CHS synchronous fMRI scan.After the experiment,the pain caused by the temperature of the subjects was scored using the visual analog scale(VAS).SPM8 and metlab2013a software were used to analyze fMRI scan image data,and single-sample t test was used to analyze the PDP group,nPDP group and control group within the group to obtain the activation of the brain area under the stimulation of contact heat pain,and the activation between the three groups Differences were compared using single-factor analysis of variance,and the reasons for the differences were analyzed.Results:1.Comparison of VAS scoresThe VAS scores of somatic pain in the PDP group and nPDP group were(5.03±0.86)and(0.38±0.72),respectively,and the difference was statistically significant(P<0.001).The VAS scores of thermal pain stimulation in the PDP group,nPDP group,and control group were(4.77±1.02),(3.88±0.62),and(3.11±0.74)respectively,and the difference was statistically significant(P<0.001).2.fMRI analysis results①CHS-fMRI activated brain areas in the control group include:bilateral thalamus,bilateral lingual gyrus,bilateral central sulcus cap,bilateral insula,bilateral cerebellum,bilateral superior temporal gyrus,bilateral supplementary motor area,bilateral tail Nucleus nucleus,bilateral marginal superior gyrus,bilateral wedges,bilateral orbital inferior frontal gyrus,bilateral triangular inferior frontal gyrus,bilateral medial cingulate gyrus,right superior temporal gyrus-temporal pole,left central anterior gyrus,left Central posterior gyrus,right amygdala,right forehead lower forehead gyrus,right forehead gyrus,right forehead gyrus,right parietal inferior corner gyrus,left hippocampal gyrus,left fusiform gyrus,right medial forehead(P<0.05).CHS-fMRI activated brain areas in the nPDP group include:bilateral cerebellum,bilateral fusiform gyrus,bilateral thalamus,bilateral central sulcus cap,bilateral superior temporal gyrus,bilateral apical and inferior marginal angle gyrus,bilateral supplementary motor area Bilateral posterior central gyrus,bilateral inferior temporal gyrus,bilateral inferior forehead gyrus,bilateral insula,bilateral temporal transverse gyrus right tongue gyrus,right temporal gyrus,left anterior central gyrus,right hippocampal gyrus Apical gyrus,left frontal gyrus,left middle lobe,left caudate nucleus(P<0.05).CHS-fMRI activated brain areas in the PDP group include:bilateral central posterior gyrus,bilateral thalamus,bilateral cerebellum,bilateral fusiform gyrus,bilateral lingual gyrus,bilateral insula,left superior temporal gyrus,bilateral central anterior gyrus Bilateral apical marginal gyrus,bilateral supplementary motor zone,bilateral paracentral lobules,bilateral hypotemporal gyrus,bilateral midtemporal gyrus,bilateral superior gyrus,right hippocampal gyrus,right orbital frontal gyrus,Right hippocampus,right central groove cover,right dorsal lateral frontal gyrus(P<0.05).② Compared with the nPDP group,the PDP group had stronger activation than the nPDP group.The brain regions include:right cerebellum,right hippocampal gyrus,right tongue gyrus,right dorsolateral frontal gyrus,right orbital frontal gyrus,and the degree of activation is weak.The brain regions in the nPDP group included:bilateral inferior temporal gyrus,bilateral insula,left central sulcus cover,left superior gyrus,and left superior apex marginal gyrus(P<0.05).Compared with the control group,the nPDP group had stronger activation intensity than the control group.The brain areas include:bilateral cerebellum,bilateral fusiform gyrus,bilateral insula,right hippocampal gyrus,left thalamus,bilateral central sulcus,Left superior temporal gyrus,left central anterior gyrus,left central posterior gyrus,right hippocampus,left apical marginal corner gyrus,left supplementary motor zone,upper left frontal gyrus,left temporal transverse gyrus,right lower temporal gyrus,upper left apical gyrus,not See brain regions with reduced activation(P<0.05).Compared with the control group,the PDP group had more activated brain areas than the control group:bilateral cerebellum,bilateral central anterior gyrus,left subtemporal gyrus,left central posterior gyrus,right hippocampal gyrus,right hippocampus,right tongue The gyrus,the left thalamus,the left superior temporal gyrus,the right insula,the right central sulcus,the left superior temporal gyrus,the left supplementary motor area,and the right fusiform gyrus showed no reduced brain area(P<0.05).③There was a correlation between the VAS score of somatic pain and pain in the PDP group,which mainly activated the left temporal gyrus of the brain area(P<0.01).Conclusion:1.CHS-fIRI study results of PDP group,nPDP group and normal control group showed that multiple brain regions were activated,which verified that multiple brain regions participate in the formation and processing of pain sensation,and there is a complex pain network.2.CHS-fMRI can provide objective means for the study of pain-related brain function in PD patients,and further reveal the pathophysiological mechanism of PDP pain from functional images,which may help to provide reference information for the diagnosis and treatment evaluation of PD patients.