The Change Of Functional Connectivity Between Raphe Nuclei And The Whole Brain In Parkinson’s Disease With Chronic Pain

Background and ObjectivePain is one of the most common non-motor symptoms in Parkinson’s disease(PD),which has various clinical phenomena,complicated pathophysiological mechanisms.The nigrostriatal dopaminergic system plays a major role in the pathogenesis of Parkinson’s disease patient with pain,However,it has also been found clinically that some patients also accompained with pain during the "opening period".Therefore,we speculate that non-dopaminergic neurotransmitters are also involved in the treatment of Parkinson’s disease pain.Studies suggested that 5-HT neurotransmitter may be involved in the treatment of pain in Parkinson’s disease,the raphe nuclei is rich in 5-HT neurotransmitters,which has extensive fibers with various parts of the central nervous system,so we hypothesized that there is a specific functional connectivity between the raphe nuclei and the whole brain in PD patients with pain.MethodsFifteen patients with PD and pain(PDP),sixteen patients with PD andno Pain(nPDP),and eighteen matched normal controls(NCs)were recrutied for the present study.All participants underwent resting-state functional connectivity(RS-FC)analysis to explore the change of functional activity between raphe nuclei and the whole brain.ReultsWe found that compared with the nPDP group,the PDP group showed a stronger functional connection between raphe nuclei and pain-related brain region,including anterior cingulum cortex(ACC.),prefrontal cortex(PFC),insular cortex,parietal lobe,not only that,but the functional connection values were significantly positively correlated with pain scores.Increased connectivity may be an independent related factors of Parkinson’s disease with chronic pain.ConclusionsTherefore,we further reveal the pathophysiological mechanism of Parkinson’s disease with pain from functional images,providing imaging evidence that 5-HT transmitters may participate in the treatment of Parkinson’s disease with pain.