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Gray matter alterations in chronic pain: A network-oriented meta-analytic approach

机译：慢性疼痛中的灰质改变：一种面向网络的荟萃分析方法

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Several studies have attempted to characterize morphological brain changes due to chronic pain. Although it has repeatedly been suggested that longstanding pain induces gray matter modifications, there is still some controversy surrounding the direction of the change (increase or decrease in gray matter) and the role of psychological and psychiatric comorbidities. In this study, we propose a novel, network-oriented, meta-analytic approach to characterize morphological changes in chronic pain. We used network decomposition to investigate whether different kinds of chronic pain are associated with a common or specific set of altered networks. Representational similarity techniques, network decomposition and model-based clustering were employed: i) to verify the presence of a core set of brain areas commonly modified by chronic pain; ii) to investigate the involvement of these areas in a large-scale network perspective; iii) to study the relationship between altered networks and; iv) to find out whether chronic pain targets clusters of areas. Our results showed that chronic pain causes both core and pathology-specific gray matter alterations in large-scale networks. Common alterations were observed in the prefrontal regions, in the anterior insula, cingulate cortex, basal ganglia, thalamus, periaqueductal gray, post- and pre-central gyri and inferior parietal lobule. We observed that the salience and attentional networks were targeted in a very similar way by different chronic pain pathologies. Conversely, alterations in the sensorimotor and attention circuits were differentially targeted by chronic pain pathologies. Moreover, model-based clustering revealed that chronic pain, in line with some neurodegenerative diseases, selectively targets some large-scale brain networks. Altogether these findings indicate that chronic pain can be better conceived and studied in a network perspective.
机译：数项研究试图表征由于慢性疼痛引起的形态学脑部变化。尽管已经反复提出长期疼痛会引起灰质改变，但是围绕变化的方向（灰质增加或减少）以及心理和精神病合并症的作用仍然存在一些争议。在这项研究中，我们提出了一种新颖的，面向网络的荟萃分析方法来表征慢性疼痛的形态变化。我们使用网络分解来研究不同类型的慢性疼痛是否与一组共同的或特定的改变的网络有关。采用了代表性相似性技术，网络分解和基于模型的聚类：i）验证通常由慢性疼痛改变的一组核心大脑区域的存在； ii）从大规模网络角度调查这些领域的参与； iii）研究变更后的网络之间的关系；以及iv）找出慢性疼痛是否针对区域集群。我们的结果表明，慢性疼痛会导致大规模网络中核心和病理学特定的灰质改变。在额叶前额区，前岛鞘，扣带回皮层，基底神经节，丘脑，导水管周围灰色，中央后回和中央前回和顶下小叶均观察到常见改变。我们观察到，不同的慢性疼痛病理学以非常相似的方式针对显着性和注意力网络。相反，感觉运动和注意回路的改变是慢性疼痛病理学的不同目标。此外，基于模型的聚类分析表明，与某些神经退行性疾病相一致的慢性疼痛选择性地针对了一些大规模的大脑网络。总而言之，这些发现表明，从网络角度可以更好地构思和研究慢性疼痛。

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