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首页> 外文期刊>Pain medicine : >Structural Brain Alterations Before and After Total Knee Arthroplasty: A Longitudinal Assessment
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Structural Brain Alterations Before and After Total Knee Arthroplasty: A Longitudinal Assessment

机译：全膝关节置换术前后结构脑改变：纵向评估

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Objective. Many studies have provided evidence of altered brain structure in chronic pain conditions, as well as further adaptations following treatment that are coincident with changes in pain. Less is known regarding how these structural brain adaptations relate to assessments of nociceptive processing. The current study aimed to investigate brain structure in people with knee osteoarthritis (OA) before and after total knee arthroplasty (TKA) and to investigate the relationships between these findings and quantitative sensory testing (QST) of the nociceptive system. Methods. Twenty-nine people with knee OA underwent magnetic resonance imaging (MRI) scans and QST before and six months after TKA and were compared with a pain-free control group (N = 18). MRI analyses involved voxel-based morphometry and fractional anisotropy. Results. Before TKA, there was reduced gray matter volume and impaired fractional anisotropy in areas associated with nociceptive processing, with further gray matter adaptations and improvements in fractional anisotropy evident after TKA. QST revealed increased nociceptive facilitation and impaired inhibition in knee OA that was reversed after TKA. There were minimal relationships found between MRI data and QST assessments or pain report. Conclusions. In people with end-stage knee OA, region-specific gray matter atrophy was detected, with further changes in gray matter volume and improvements in white matter integrity observed after joint replacement. Despite coincident alterations in nociceptive inhibition and facilitation processes, there did not appear to be any association between these functional assessments of the nociceptive system and changes in brain structure.
机译：客观的。许多研究提供了慢性疼痛条件下脑结构改变的证据，以及在处理疼痛变化的治疗后进一步适应。关于这些结构脑适应如何与伤害性加工的评估有关的较少。目前的研究旨在研究全膝关节成形术（TKA）之前和之后的膝关节骨关节炎（OA）的人们的脑结构，并研究伤害系统的这些发现与定量感官测试（QST）之间的关系。方法。膝关节OA的二十九人接受磁共振成像（MRI）扫描和QST在TKA之前和六个月之前，并与无止痛对照组进行比较（n = 18）。 MRI分析涉及基于体素的形态学和分数各向异性。结果。在TKA之前，灰质体积减少和与伤害性加工相关的区域的分数各向异性受损，具有进一步的灰质适应和TKA后的分数各向异性的改进。 QST揭示了在TKA后逆转的膝关节OA中的伤害性促进和抑制受损。 MRI数据和QST评估或止痛报告之间发现了最小的关系。结论。在末期膝盖OA的人们中，检测到地区特异性灰质物质萎缩，灰质体积的进一步变化和接头置换后观察到的白质完整性的改善。尽管有伤害性抑制和促进过程的改变巧合，但这些功能评估与伤害性系统的这些功能评估和脑结构变化之间没有任何关联。

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