Comorbid depressive symptoms can aggravate the functional changes of the pain matrix in patients with chronic back pain: A resting-state fMRI study
Objective The purposes of this study are to explore (1) whether comorbid depressive symptoms in patients with chronic back pain (CBP) affect the pain matrix. And (2) whether the interaction of depression and CBP exacerbates impaired brain function. Methods Thirty-two patients with CBP without comorb...
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Published in | Frontiers in aging neuroscience Vol. 14; p. 935242 |
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Main Authors | , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Frontiers Media S.A
18.07.2022
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Subjects | |
Online Access | Get full text |
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Summary: | Objective
The purposes of this study are to explore (1) whether comorbid depressive symptoms in patients with chronic back pain (CBP) affect the pain matrix. And (2) whether the interaction of depression and CBP exacerbates impaired brain function.
Methods
Thirty-two patients with CBP without comorbid depressive symptoms and thirty patients with CBP with comorbid depressive symptoms were recruited. All subjects underwent functional magnetic resonance imaging (fMRI) scans. The graph theory analysis, mediation analysis, and functional connectivity (FC) analysis were included in this study. All subjects received the detection of clinical depressive symptoms and pain-related manifestations.
Result
Compared with the CBP group, subjects in the CBP with comorbid depressive symptoms (CBP-D) group had significantly increased FC in the left medial prefrontal cortex and several parietal cortical regions. The results of the graph theory analyses showed that the area under the curve of small-world property (
t
= −2.175,
p
= 0.034), gamma (
t
= −2.332,
p
= 0.023), and local efficiency (
t
= −2.461,
p
= 0.017) in the CBP-D group were significantly lower. The nodal efficiency in the ventral posterior insula (VPI) (
t
= −3.581,
p
= 0.0007), and the network efficiency values (
t
= −2.758,
p
= 0.008) in the pain matrix were significantly lower in the CBP-D group. Both the topological properties and the FC values of these brain regions were significantly correlated with self-rating depression scale (SDS) scores (all FDR corrected) but not with pain intensity. Further mediation analyses demonstrated that pain intensity had a mediating effect on the relationship between SDS scores and Pain Disability Index scores. Likewise, the SDS scores mediated the relationship between pain intensity and PDI scores.
Conclusion
Our study found that comorbid depressive symptoms can aggravate the impairment of pain matrix function of CBP, but this impairment cannot directly lead to the increase of pain intensity, which may be because some brain regions of the pain matrix are the common neural basis of depression and CBP. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Edited by: Howe Liu, University of North Texas Health Science Center, United States Reviewed by: Jie Jia, Fudan University, China; Nicoletta Cera, University of Porto, Portugal These authors have contributed equally to this work and share first authorship This article was submitted to Neurocognitive Aging and Behavior, a section of the journal Frontiers in Aging Neuroscience |
ISSN: | 1663-4365 1663-4365 |
DOI: | 10.3389/fnagi.2022.935242 |