Research On Brain Function And Structure Of Patients With Ankylosing Spondylitis And Low Back Pain Based On Resting State Functional Magnetic Resonance And VBM

Part One.Altered dynamic ReHo and dynamic functional connectivity in ankylosing spondylitis patientsPurpose:Ankylosing spondylitis(AS)mainly involves the axial skeleton,which is an important factor of chronic lower back pain in young people.Previous neuroimaging studies have shown abnormal resting state functional connectivity(FC)in patients with ankylosing spondylitis.However,the existing research on AS have rarely examined the dynamic changes in resting-state FC with network formation,and interaction.This study intends to study the dynamic Reho and dynamic FC between AS patients and healthy controls(HC).Materials and methods:This study included 64 confirmed patients with ankylosing spondylitis and 53 healthy controls whose age,sex and education level matched.Resting state functional magnetic resonance imaging(fMRI)was used to compare the differences of dynamic Reho and dynamic functional connectivity between the two groups.At the same time,correlation analysis was used to study whether the dreho and dFC values of abnormal brain areas in patients with ankylosing spondylitis were correlated with clinical related indicators.Result:Compared with the healthy control group,the dReHo value of patients with ankylosing spondylitis(AS)in the Precuneus(PCu)increased.In addition,we also found that the dFC value of the left Precuneus(PCu)and the left lingual,the middle occipital lobe and the left postcentral gyrus decreased.We also found a positive correlation between the dReHo value of the left Precuneus and the duration of AS,the score of the TBP scale,and also with the BASDAI score.The dFC value of the left postcentral gyrus is negative correlated with the duration of AS and the score of the TBP scale.Conclusion:These findings preliminarily prove that patients with AS show changes in dynamic Reho and dynamic FC in part of the brain area of multiple resting brain networks.The dReHo value or dFC value of part of the brain area in the default network,sensory motor network and visual network are abnormality.There is close connection between pain perception and some clinical correlation indicators in patients with direct spondylitis.Dynamic functional connection within the brain network of patients with an abnormal ankylosing spondylitis discusses the pain mechanism it may involve,further increases the understanding of the brain network of pain in patients with ankylosing spondylitis,and provides a basic theoretical basis for clinical treatment.Part Two.Increased Left Putamen Volume Correlates With Pain in Ankylosing Spondylitis PatientsPurpose:Ankylosing spondylitis(AS)mainly affects the axial skeleton and is an important factor leading to chronic lower back pain in young individuals.However,few studies have explored alterations of brain gray matter volume in AS patients.The purpose of the present study was to describe brain gray matter abnormalities associated with AS pain.Materials and methods:A total of 64 AS patients and 53 healthy controls(HCs)were included in this study.Using voxel-based morphometrics,we detected abnormal gray matter volume in AS patients.Result:Based on the voxel-wise analysis,the gray matter volume in the left putamen of the AS group was increased significantly compared with that of the HC group.In addition,we found that the gray matter volume of the left putamen was positively correlated with the duration of AS and total back pain scores,whereas it was not significantly correlated with Bath Ankylosing Spondylitis Disease Activity Index scores,C-reactive protein,or erythrocyte sedimentation rate in AS patients.Conclusion:Taken together,our findings improve our understanding of the neural substrates of pain in AS and provide evidence of AS-related neurological impairment.Hence,further investigation of the pathophysiology of the left putamen in AS is warranted.