熟能生巧?突出网络和躯体感觉网络的功能连通性可预测纤维肌痛的心身治疗反应

IF 2.5 Q2 CLINICAL NEUROLOGY Frontiers in pain research (Lausanne, Switzerland) Pub Date : 2024-09-05 eCollection Date: 2024-01-01 DOI:10.3389/fpain.2024.1245235
Sonia Medina, Owen O'Daly, Matthew A Howard, Albert Feliu-Soler, Juan V Luciano
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引用次数: 0

摘要

背景:身心疗法可以改善应对疼痛的机制,提高纤维肌痛综合征(FMS)患者的生活质量,并在某些情况下减轻患者的疼痛感。然而,对这些疗法的反应差异很大,其机制仍不清楚,也缺乏可靠的治疗反应预测指标。我们采用静息状态血氧水平依赖性(rsBOLD)功能磁共振成像(fMRI)来研究心身治疗后大脑功能连通性(FC)的变化,这些变化可能与疼痛缓解有关并可预测疼痛缓解:我们招募了接受正念减压疗法(MBSR;n = 18)或心理教育计划(FibroQoL;n = 22)治疗的 FMS 患者,以及接受常规治疗的 FMS 组(TAU;n = 18)患者。我们收集了rsBOLD数据,以及治疗前后的主观疼痛、焦虑、抑郁和灾难化测量数据。我们检查了行为变化以及显著性网络(SN)和感觉运动网络(SMN)中的FC变化,并进行了回归分析,以确定治疗反应的预测因素:结果:MBSR 组和 FibroQoL 组的疼痛灾难化程度显著降低。治疗后,MBSR 组与 TAU 组相比,感觉运动皮层与 SMN 其他部分的 FC 显著降低。基线时,SN与SMN之间的FC与MBSR治疗后疼痛减轻呈负相关,但与纤维QoL组疼痛减轻呈正相关。这些结果产生了较大或非常大的效应量。在进行 MBSR 后,只有那些 SMN-SN FC 基线较低的患者,正念练习的分钟数与临床改善呈正相关(小到中等效应大小):结论:不同的身心治疗方法由不同的大脑网络支撑。对SN和SMN之间功能相互作用的测量有可能成为FMS患者身心治疗反应的预测指标。
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Does practice make perfect? Functional connectivity of the salience network and somatosensory network predicts response to mind-body treatments for fibromyalgia.

Background: Mind-body treatments can improve coping mechanisms to deal with pain, improve the quality of life of patients with fibromyalgia syndrome (FMS), and reduce perceived pain in some cases. However, responses to these treatments are highly variable, the mechanisms underpinning them remain unclear, and reliable predictors of treatment response are lacking. We employed resting-state blood oxygen level-dependent (rsBOLD) functional magnetic resonance imaging (fMRI) to examine changes in brain functional connectivity (FC) following mind-body treatment that may relate to and predict pain relief.

Methods: We recruited patients with FMS who underwent either mindfulness-based stress reduction (MBSR; n = 18) or a psychoeducational program (FibroQoL; n = 22) and a treatment-as-usual FMS group (TAU; n = 18). We collected rsBOLD data, alongside subjective pain, anxiety, depression, and catastrophizing measures prior to and following treatments. We examined behavioral changes and FC changes in the salience network (SN) and sensorimotor network (SMN) and performed regression analyses to identify predictors for treatment response.

Results: The MBSR and FibroQoL groups experienced significant reductions in pain catastrophizing. After treatment, the FC of the sensorimotor cortex with the rest of the SMN became significantly reduced in the MBSR group compared to the TAU group. The FC between the SN and the SMN at baseline was negatively correlated with pain reductions following MBSR but positively correlated with pain reductions in the FibroQoL group. These results yielded large to very large effect sizes. Following MBSR, only for those patients with lower baseline SMN-SN FC, minutes of mindfulness practice were positively associated with clinical improvement (small to medium effect size).

Conclusions: Different mind-body treatments are underpinned by discrete brain networks. Measures of the functional interplay between SN and SMN have the potential as predictors of mind-body treatment response in patients with FMS.

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