Abnormalities of insular functional connectivity in patients with musculoskeletal pain: A meta-analysis of resting-state fMRI studies

IF 3.7 3区医学 Q2 NEUROSCIENCES Brain Research Bulletin Pub Date : 2025-05-01 Epub Date: 2025-03-11 DOI:10.1016/j.brainresbull.2025.111294

Peng Lai , Xingyao Chen , Jiacheng Liu , Zilei Tian , Yangke Mao , Chenyang Jia , Siting Ma , Deliang Zhu , Ming Xin , Fang Zeng , Shirui Cheng

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Abstract

Background

Resting-state functional magnetic resonance imaging (fMRI) studies have shown abnormal functional connectivity (FC) of the insula (INS) in patients with musculoskeletal pain (MSP). However, there is a lack of consistency in previous studies, which is an obstacle to understanding the underlying neuropathology of MSP.

Method

Seven databases, including PubMed, Web of Science, the Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chongqing VIP, were systematically searched from inception to 15 May 2024. The meta-analysis of the aberrant INS-based FC in MSP patients was performed using the anisotropic effect-size signed differential mapping (AES-SDM).

Results

A total of eleven neuroimaging studies with 276 patients and 253 HCs were included in the meta-analysis. The results indicate that MSP patients have increased FC between INS and the right median cingulate gyri, right inferior frontal gyrus, right paracentral lobule, and right supplementary motor area, and decreased FC between INS and the right posterior cingulate gyrus, left precuneus, and left angular gyrus. Heterogeneity and sensitivity analysis showed that most of the results of INS-based FC were highly reproducible and robust. Meta-regression analysis showed that revealed a negative association between the Visual Analog Scale (VAS) score and the reduction in FC between the INS and the left precuneus.

Conclusion

The meta-analysis reveals that patients with MSP show abnormal FC between the INS and multiple brain regions, which are involved in emotional, cognitive, sensory, visuospatial and motor regulation of pain. These findings provide important insights into the underlying neuropathological mechanisms of musculoskeletal disorders.

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肌肉骨骼疼痛患者的岛岛功能连通性异常：静息状态fMRI研究的荟萃分析。

背景：静息状态功能磁共振成像（fMRI）研究显示，肌肉骨骼疼痛（MSP）患者的脑岛（INS）功能连接异常（FC）。然而，以往的研究缺乏一致性，这对了解MSP的潜在神经病理是一个障碍。方法：系统检索PubMed、Web of Science、Cochrane Library、Embase、中国知网（CNKI）、万方数据库、重庆维普（Chongqing VIP）等7个数据库，检索时间为建库至2024年5月15日。采用各向异性效应大小符号差分映射（AES-SDM）对MSP患者异常的基于ins的FC进行meta分析。结果：荟萃分析共纳入了11项神经影像学研究，涉及276例患者和253例hcc。结果表明，MSP患者INS与右侧扣带中回、右侧额下回、右侧中央旁小叶和右侧辅助运动区之间的FC增加，INS与左侧楔前叶和左侧角回之间的FC减少。异质性和敏感性分析表明，大多数基于ins的FC结果具有高重复性和鲁棒性。meta回归分析显示，视觉模拟量表（VAS）评分与INS与左楔前叶间FC的减少呈负相关。结论：meta分析显示MSP患者在INS与多个脑区之间存在异常的FC，这些脑区涉及疼痛的情绪、认知、感觉、视觉空间和运动调节。这些发现为肌肉骨骼疾病的潜在神经病理机制提供了重要的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain Research Bulletin 医学-神经科学

CiteScore

6.90

自引率

2.60%

发文量

253

审稿时长

67 days

期刊介绍： The Brain Research Bulletin (BRB) aims to publish novel work that advances our knowledge of molecular and cellular mechanisms that underlie neural network properties associated with behavior, cognition and other brain functions during neurodevelopment and in the adult. Although clinical research is out of the Journal''s scope, the BRB also aims to publish translation research that provides insight into biological mechanisms and processes associated with neurodegeneration mechanisms, neurological diseases and neuropsychiatric disorders. The Journal is especially interested in research using novel methodologies, such as optogenetics, multielectrode array recordings and life imaging in wild-type and genetically-modified animal models, with the goal to advance our understanding of how neurons, glia and networks function in vivo.