A Research Of The Default Mode Network In Patients With Chronic Neck And Shoulder Pain Of Cervical Spondylotic Radiculopathy

Objective: To explore the changes of DMN functional connections in cervical spondylotic radiculopathy(CSR)patients with chronic neck and shoulder pain by independent component analysis(ICA),to analyze the correlation between the change of default network function connection and clinical pain score in patients with chronic neck and shoulder pain,and to explore the neural mechanism of pain in patients with chronic neck and shoulder pain of nerve root type cervical spondylosis.Methods:(1)14 patients with chronic neck and shoulder pain and 15 healthy controls were scanned with conventional magnetic resonance,high resolution 3D-T1 structural imaging and resting state functional magnetic resonance(rs-f MRI)using 3.0T MR;(2)VAS was performed at the end of the scan.ICA was used to separate and extract the DMN.The changes of the DMN functional connections between the two groups were compared and analyzed;(3)Pearson correlation analysis was made between the functional connections strength of different brain regions and VAS score.Results:(1)The functional connections of thalamus,hippocampus,basal nucleus,left middle temporal gyrus and anterior cuneiform lobe decreased,and the functional connections of right superior temporal gyrus increased in patients;(2)There was a negative correlation between hippocampal functional connections and VAS score(r=-0.546,P=0.043).Conclusion: The changes of functional connections of DMN in patients with chronic pain of CSR may be related to the changes of cognitive pain processing,emotional processing and memory function in patients with chronic pain of CSR.The decrease of DMN functional connection can reduce the memory and alertness of chronic pain;the enhancement of DMN functional connection may reflect the brain's attention and focus on pain.There was a negative correlation between VAS score and the strength of functional connections in hippocampus.With the increase of pain score,the strength of functional connections in hippocampus increased negatively.It indicated that the pain intensity increased,and the ability of memory and avoiding injury of hippocampus increased.