A Study Of Resting-State Functional Magnetic Resonance Imaging (RS-fmri) For Chronic Pain In Knee Osteoarthritis

Part one1.Purpose:The rs-fmri data analysis was used to study the changes of brain functional activity in chronic pain patients with knee osteitis compared with healthy people,and to explore the correlation between the changes in functional activity and clinical pain symptoms.2.Materials and methods:Twenty-seven patients with knee arthritis clinically diagnosed from November 2018 to November 2019,and 25 healthy volunteers with age and gender matching were collected.The subjects were divided into two groups: knee arthritis group(KOA group)and healthy control group(HC group).1.5mm or rotation Angle in any direction >1.5°,1 case data of each KOA group and HC group were excluded,and 26 cases of KOA group and 24 cases of HC group were finally removed.Clinical indicators including gender,age,height,weight and VAS in the KOA group and HC group were collected and statistically analyzed between the two groups,using P<.0.05 was considered statistically significant.Rs-fmri data of KOA group and HC group were collected,and the DPABI toolbox was used to process the BOLD signal data of(rs-fmri)by low-frequency amplitude(ALFF/fALFF),local consistency(ReHo),independent component analysis(ICA),and functional connectivity(FC)respectively,and the corresponding indicators were statistically analyzed for the two groups.FC values of the anterior cingulate gyrus of each subject in the KOA group were extracted,and Pearson correlation analysis was conducted between the FC values and VAS values of each subject in the KOA group using SPSS22.3.Results :There was no significant statistical difference between the KOA group and HC group in terms of gender,age,height and weight(P >0.05).Compared with HC group,the KOA group showed: 1)decreased ALFF in the left prefrontal cortex,bilateral posterior central gyrus,left middle temporal gyrus,right posterior occipital cortex,right precuneus and precuneus(P<0.005,cluster size >20);2)fALFF decreased in the right inferior temporal gyrus,right posterior central gyrus,right dorsolateral frontal cortex,right orbital inferior frontal gyrus,right medial frontal gyrus,superior marginal gyrus,occipital cortex,bilateral anterior central gyrus,and bilateral parietal cortex(p<0.005,and the cluster size >10)3)decreased occipital cortex,bilateral medial frontal gyrus,left anterior central gyrus,bilateral superior marginal gyrus,anterior cingulate gyrus,and left thalamus ReHo(p<0.005,and the cluster size >50);The functional connections of the right dorsolateral frontal cortex(DLPFC)as seed points showed decreased functional connections in the left occipital cortex,left posterior central gyrus,right anterior cingulate gyrus,right inferior temporal gyrus,right marginal superior gyrus,prefrontal cortex and cerebellum regions(P<0.005,cluster size >20).With right DLPFC as the region of interest,the FC value in the region of right anterior cingulate gyrus(ACC)was negatively correlated with the corresponding VAS value(r=-0.645,p<0.05).4.Conclusion:(1)chronic pain in knee osteoarthritis shows reduced functional activity in a wide range of brain regions involved in pain perception and regulation.(2)chronic pain in knee osteoarthritis results in the destruction of connectivity within the default mode network.(3)the strength of functional connection between DLPFC and ACC can reflect the pain degree of patients with chronic pain to a certain extent.Part 21.Purpose:The rs-fmri data were used to analyze the changes of brain functional activity in patients with chronic pain after treatment compared with those before treatment,and the correlation between the changes in functional activity after treatment and the prognosis of corresponding pain symptoms was discussed.2.Materials and methods:The pre-and post-treatment data were collected from 12 patients with knee arthritis clinically diagnosed from November 2018 to November 2019 who underwent clinical symptomatic anti-inflammatory therapy.The VAS values of the pre-koa and post-koa groups were collected,SPSS22 was used,and repeated measurement anova was performed.Use P<0.05 was considered statistically significant.Rs-fmri data of the KOA pre-treatment group and the post-treatment group were collected,and the DPABI toolbox was used to process the BOLD signal data of(rs-fmri)by low-frequency amplitude(ALFF/fALFF),local consistency(ReHo),independent component analysis(ICA),and functional connectivity(FC),respectively,and the corresponding indicators were statistically analyzed for the two groups.FC values of the anterior cingulate gyrus of each subject in the KOA treatment group were extracted,and Pearson correlation analysis was performed between the FC values of the KOA treatment group and the corresponding VAS using SPSS22.3.Results:The functional connections between the right dorsolateral frontal cortex(DLPFC)and the anterior cingulate gyrus(ACC)were stronger in the KOA group than in the HC group(p<0.005,and the cluster size >10).The function connection between DLPFC and ACC(FC value)was negatively correlated with corresponding VAS(r=-0.632,p<0.05).Repeated measures anova was performed between the KOA group and HC group in low-frequency amplitude(ALFF/fALFF),local consistency(ReHo),and independent component analysis ICA DMN,respectively,and no significant differences were found in brain regions(P<0.005,voxel size >10).4.Conclusion:(1)the enhancement of functional connectivity in the area of interest of the prefrontal cortex(DLPFC)suggests that patients with chronic pain of knee arthritis may have some degree of enhanced analgesic regulation network after treatment.(2)FC values based on DLPFC-ACC can be used to assess the pain degree of knee arthritis after treatment.