Taylor D Yeater, David J Clark, Lorraine Hoyos, Pedro A Valdes-Hernandez, Julio A Peraza, Kyle D Allen, Yenisel Cruz-Almeida
{"title":"慢性疼痛与简单和复杂步行任务中交感神经系统反应性降低有关:潜在的大脑机制","authors":"Taylor D Yeater, David J Clark, Lorraine Hoyos, Pedro A Valdes-Hernandez, Julio A Peraza, Kyle D Allen, Yenisel Cruz-Almeida","doi":"10.1177/24705470211030273","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Autonomic dysregulation may lead to blunted sympathetic reactivity in chronic pain states. Autonomic responses are controlled by the central autonomic network (CAN). Little research has examined sympathetic reactivity and associations with brain CAN structures in the presence of chronic pain; thus, the present study aims to investigate how chronic pain influences sympathetic reactivity and associations with CAN brain region volumes.</p><p><strong>Methods: </strong>Sympathetic reactivity was measured as change in skin conductance level (ΔSCL) between a resting reference period and walking periods for typical and complex walking tasks (obstacle and dual-task). Participants included 31 people with (n = 19) and without (n = 12) chronic musculoskeletal pain. Structural 3 T MRI was used to determine gray matter volume associations with ΔSCL in regions of the CAN (i.e., brainstem, amygdala, insula, and anterior cingulate cortex).</p><p><strong>Results: </strong>ΔSCL varied across walking tasks (main effect p = 0.036), with lower ΔSCL in chronic pain participants compared to controls across trials 2 and 3 under the obstacle walking condition. ΔSCL during typical walking was associated with multiple CAN gray matter volumes, including brainstem, bilateral insula, amygdala, and right caudal anterior cingulate cortex (p's < 0.05). The difference in ΔSCL from typical-to-obstacle walking were associated with volumes of the midbrain segment of the brainstem and anterior segment of the circular sulcus of the insula (p's < 0.05), with no other significant associations. The difference in ΔSCL from typical-to-dual task walking was associated with the bilateral caudal anterior cingulate cortex, and left rostral cingulate cortex (p's < 0.05).</p><p><strong>Conclusions: </strong>Sympathetic reactivity is blunted during typical and complex walking tasks in persons with chronic pain. Additionally, blunted sympathetic reactivity is associated with CAN brain structure, with direction of association dependent on brain region. These results support the idea that chronic pain may negatively impact typical autonomic responses needed for walking performance via its potential impact on the brain.</p>","PeriodicalId":52315,"journal":{"name":"Chronic Stress","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/2d/10.1177_24705470211030273.PMC8267022.pdf","citationCount":"0","resultStr":"{\"title\":\"Chronic Pain is Associated With Reduced Sympathetic Nervous System Reactivity During Simple and Complex Walking Tasks: Potential Cerebral Mechanisms.\",\"authors\":\"Taylor D Yeater, David J Clark, Lorraine Hoyos, Pedro A Valdes-Hernandez, Julio A Peraza, Kyle D Allen, Yenisel Cruz-Almeida\",\"doi\":\"10.1177/24705470211030273\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Autonomic dysregulation may lead to blunted sympathetic reactivity in chronic pain states. 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Structural 3 T MRI was used to determine gray matter volume associations with ΔSCL in regions of the CAN (i.e., brainstem, amygdala, insula, and anterior cingulate cortex).</p><p><strong>Results: </strong>ΔSCL varied across walking tasks (main effect p = 0.036), with lower ΔSCL in chronic pain participants compared to controls across trials 2 and 3 under the obstacle walking condition. ΔSCL during typical walking was associated with multiple CAN gray matter volumes, including brainstem, bilateral insula, amygdala, and right caudal anterior cingulate cortex (p's < 0.05). The difference in ΔSCL from typical-to-obstacle walking were associated with volumes of the midbrain segment of the brainstem and anterior segment of the circular sulcus of the insula (p's < 0.05), with no other significant associations. The difference in ΔSCL from typical-to-dual task walking was associated with the bilateral caudal anterior cingulate cortex, and left rostral cingulate cortex (p's < 0.05).</p><p><strong>Conclusions: </strong>Sympathetic reactivity is blunted during typical and complex walking tasks in persons with chronic pain. Additionally, blunted sympathetic reactivity is associated with CAN brain structure, with direction of association dependent on brain region. 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引用次数: 0
摘要
背景:在慢性疼痛状态下,自律神经失调可能会导致交感神经反应迟钝。自律神经反应由中枢自律神经网络(CAN)控制。目前很少有研究探讨慢性疼痛时交感神经的反应性以及与大脑CAN结构的关联;因此,本研究旨在探讨慢性疼痛如何影响交感神经的反应性以及与CAN脑区体积的关联:交感神经反应性是通过皮肤电导水平(ΔSCL)在静息参考期和典型及复杂步行任务(障碍和双重任务)步行期之间的变化来测量的。参与者包括 31 名慢性肌肉骨骼疼痛患者(19 人)和非慢性肌肉骨骼疼痛患者(12 人)。结果:ΔSCL 在不同的行走任务中存在差异(主效应 p = 0.036),在障碍行走条件下,慢性疼痛参与者在试验 2 和 3 中的ΔSCL 低于对照组。典型行走过程中的ΔSCL与多个CAN灰质体积相关,包括脑干、双侧脑岛、杏仁核和右侧尾状前扣带回皮层(P的结论):慢性疼痛患者在典型和复杂的行走任务中交感神经反应性减弱。此外,交感神经反应性减弱与 CAN 脑结构有关,其关联方向取决于脑区。这些结果支持了这样一种观点,即慢性疼痛可能会通过其对大脑的潜在影响,对行走表现所需的典型自律神经反应产生负面影响。
Chronic Pain is Associated With Reduced Sympathetic Nervous System Reactivity During Simple and Complex Walking Tasks: Potential Cerebral Mechanisms.
Background: Autonomic dysregulation may lead to blunted sympathetic reactivity in chronic pain states. Autonomic responses are controlled by the central autonomic network (CAN). Little research has examined sympathetic reactivity and associations with brain CAN structures in the presence of chronic pain; thus, the present study aims to investigate how chronic pain influences sympathetic reactivity and associations with CAN brain region volumes.
Methods: Sympathetic reactivity was measured as change in skin conductance level (ΔSCL) between a resting reference period and walking periods for typical and complex walking tasks (obstacle and dual-task). Participants included 31 people with (n = 19) and without (n = 12) chronic musculoskeletal pain. Structural 3 T MRI was used to determine gray matter volume associations with ΔSCL in regions of the CAN (i.e., brainstem, amygdala, insula, and anterior cingulate cortex).
Results: ΔSCL varied across walking tasks (main effect p = 0.036), with lower ΔSCL in chronic pain participants compared to controls across trials 2 and 3 under the obstacle walking condition. ΔSCL during typical walking was associated with multiple CAN gray matter volumes, including brainstem, bilateral insula, amygdala, and right caudal anterior cingulate cortex (p's < 0.05). The difference in ΔSCL from typical-to-obstacle walking were associated with volumes of the midbrain segment of the brainstem and anterior segment of the circular sulcus of the insula (p's < 0.05), with no other significant associations. The difference in ΔSCL from typical-to-dual task walking was associated with the bilateral caudal anterior cingulate cortex, and left rostral cingulate cortex (p's < 0.05).
Conclusions: Sympathetic reactivity is blunted during typical and complex walking tasks in persons with chronic pain. Additionally, blunted sympathetic reactivity is associated with CAN brain structure, with direction of association dependent on brain region. These results support the idea that chronic pain may negatively impact typical autonomic responses needed for walking performance via its potential impact on the brain.