DOI QR코드

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Cerebral current-source distribution associated with pain improvement by non-invasive painless signaling therapy in patients with failed back surgery syndrome

  • Lee, Chang Han (Department of Rehabilitation Medicine, Gyeongsang National University Hospital) ;
  • Kim, Hyeong Seop (Department of Rehabilitation Medicine, Gyeongsang National University Hospital) ;
  • Kim, Young-Soo (Department of Neurology, Gyeongsang National University Hospital) ;
  • Jung, Seokwon (Department of Neurology, Gyeongsang National University Hospital) ;
  • Yoon, Chul Ho (Department of Rehabilitation Medicine, Gyeongsang National University Hospital) ;
  • Kwon, Oh-Young (Department of Neurology, Gyeongsang National University Hospital)
  • 투고 : 2021.03.04
  • 심사 : 2021.06.16
  • 발행 : 2021.10.01

초록

Background: Non-invasive painless signaling therapy (NPST) is an electro-cutaneous treatment that converts endogenous pain information into synthetic non-pain information. This study explored whether pain improvement by NPST in failed back surgery syndrome (FBSS) patients is related to cerebral modulation. Methods: Electroencephalography (EEG) analysis was performed in 11 patients with FBSS. Subjects received daily NPST for 5 days. Before the first treatment, patients completed the Brief Pain Inventory (BPI) and Beck Depression Inventory and underwent baseline EEG. After the final treatment, they responded again to the BPI, reported the percent pain improvement (PPI), and then underwent post-treatment EEG. If the PPI grade was zero, they were assigned to the ineffective group, while all others were assigned to the effective group. We used standardized low-resolution brain electromagnetic tomography (sLORETA) to explore the EEG current-source distribution (CSD) associated with pain improvement by NPST. Results: The 11 participants had a median age of 67.0 years, and 63.6% were female. The sLORETA images revealed a beta-2 CSD increment in 12 voxels of the right anterior cingulate gyrus (ACG) and the right medial frontal area. The point of maximal CSD changes was in the right ACG. The alpha band CSD increased in 2 voxels of the left transverse gyrus. Conclusions: Pain improvement by NPST in FBSS patients was associated with increased cerebral activity, mainly in the right ACG. The change in afferent information induced by NPST seems to be associated with cerebral pain perception.

키워드

참고문헌

  1. Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 2014; 73: 968-74. https://doi.org/10.1136/annrheumdis-2013-204428
  2. Smith M, Davis MA, Stano M, Whedon JM. Aging baby boomers and the rising cost of chronic back pain: secular trend analysis of longitudinal Medical Expenditures Panel Survey data for years 2000 to 2007. J Manipulative Physiol Ther 2013; 36: 2-11. https://doi.org/10.1016/j.jmpt.2012.12.001
  3. Rajaee SS, Bae HW, Kanim LE, Delamarter RB. Spinal fusion in the United States: analysis of trends from 1998 to 2008. Spine (Phila Pa 1976) 2012; 37: 67-76. https://doi.org/10.1097/BRS.0b013e31820cccfb
  4. Harvey AM. Classification of chronic pain-descriptions of chronic pain syndromes and definitions of pain terms. Clin J Pain 1995; 11: 163. https://doi.org/10.1097/00002508-199506000-00024
  5. Diebo BG, Passias PG, Marascalchi BJ, Jalai CM, Worley NJ, Errico TJ, et al. Primary versus revision surgery in the setting of adult spinal deformity: a nationwide study on 10,912 patients. Spine (Phila Pa 1976) 2015; 40: 1674-80. https://doi.org/10.1097/BRS.0000000000001114
  6. Baber Z, Erdek MA. Failed back surgery syndrome: current perspectives. J Pain Res 2016; 9: 979-87. https://doi.org/10.2147/JPR.S92776
  7. Freynhagen R, Bennett MI. Diagnosis and management of neuropathic pain. BMJ 2009; 339: b3002. https://doi.org/10.1136/bmj.b3002
  8. Ricci M, Pirotti S, Scarpi E, Burgio M, Maltoni M, Sansoni E, et al. Managing chronic pain: results from an open-label study using MC5-A Calmare®device. Support Care Cancer 2012; 20: 405-12. https://doi.org/10.1007/s00520-011-1128-6
  9. Smith TJ, Coyne PJ, Parker GL, Dodson P, Ramakrishnan V. Pilot trial of a patient-specific cutaneous electrostimulation device (MC5-A Calmare®) for chemotherapy-induced peripheral neuropathy. J Pain Symptom Manage 2010; 40: 883-91. https://doi.org/10.1016/j.jpainsymman.2010.03.022
  10. Shannon CE. A mathematical theory of communication. Bell Syst Tech J 1948; 27: 379-423. https://doi.org/10.1002/j.1538-7305.1948.tb01338.x
  11. Craig AD, Reiman EM, Evans A, Bushnell MC. Functional imaging of an illusion of pain. Nature 1996; 384: 258-60. https://doi.org/10.1038/384258a0
  12. Foltz EL, White LE Jr. Pain "relief" by frontal cingulumotomy. J Neurosurg 1962; 19: 89-100. https://doi.org/10.3171/jns.1962.19.2.0089
  13. Levi V, Cordella R, D'Ammando A, Tringali G, Dones I, Messina G, et al. Dorsal anterior cingulate cortex (ACC) deep brain stimulation (DBS): a promising surgical option for the treatment of refractory thalamic pain syndrome (TPS). Acta Neurochir (Wien) 2019; 161: 1579-88. https://doi.org/10.1007/s00701-019-03975-5
  14. Peyron R, Garcia-Larrea L, Gregoire MC, Costes N, Convers P, Lavenne F, et al. Haemodynamic brain responses to acute pain in humans: sensory and attentional networks. Brain 1999; 122(Pt 9): 1765-80. https://doi.org/10.1093/brain/122.9.1765
  15. Sikes RW, Vogt BA. Nociceptive neurons in area 24 of rabbit cingulate cortex. J Neurophysiol 1992; 68: 1720-32. https://doi.org/10.1152/jn.1992.68.5.1720
  16. Vaccarino AL, Melzack R. Analgesia produced by injection of lidocaine into the anterior cingulum bundle of the rat. Pain 1989; 39: 213-9. https://doi.org/10.1016/0304-3959(89)90008-0
  17. Baumgartner U, Tiede W, Treede RD, Craig AD. Laser-evoked potentials are graded and somatotopically organized anteroposteriorly in the operculoinsular cortex of anesthetized monkeys. J Neurophysiol 2006; 96: 2802-8. https://doi.org/10.1152/jn.00512.2006
  18. Hofbauer RK, Fiset P, Plourde G, Backman SB, Bushnell MC. Dose-dependent effects of propofol on the central processing of thermal pain. Anesthesiology 2004; 100: 386-94. https://doi.org/10.1097/00000542-200402000-00031
  19. Lee MC, Mouraux A, Iannetti GD. Characterizing the cortical activity through which pain emerges from nociception. J Neurosci 2009; 29: 7909-16. https://doi.org/10.1523/JNEUROSCI.0014-09.2009
  20. Legrain V, Iannetti GD, Plaghki L, Mouraux A. The pain matrix reloaded: a salience detection system for the body. Prog Neurobiol 2011; 93: 111-24. https://doi.org/10.1016/j.pneurobio.2010.10.005
  21. Peyron R, Laurent B, Garcia-Larrea L. Functional imaging of brain responses to pain. A review and meta-analysis (2000). Neurophysiol Clin 2000; 30: 263-88. https://doi.org/10.1016/S0987-7053(00)00227-6
  22. Michel CM, Murray MM, Lantz G, Gonzalez S, Spinelli L, Grave de Peralta R. EEG source imaging. Clin Neurophysiol 2004; 115: 2195-222. https://doi.org/10.1016/j.clinph.2004.06.001
  23. He B, Sohrabpour A, Brown E, Liu Z. Electrophysiological source imaging: a noninvasive window to brain dynamics. Annu Rev Biomed Eng 2018; 20: 171-96. https://doi.org/10.1146/annurev-bioeng-062117-120853
  24. Gross J, Kujala J, Hamalainen M, Timmermann L, Schnitzler A, Salmelin R. Dynamic imaging of coherent sources: studying neural interactions in the human brain. Proc Natl Acad Sci U S A 2001; 98: 694-9. https://doi.org/10.1073/pnas.98.2.694
  25. Davis KD, Flor H, Greely HT, Iannetti GD, Mackey S, Ploner M, et al. Brain imaging tests for chronic pain: medical, legal and ethical issues and recommendations. Nat Rev Neurol 2017; 13: 624-38. https://doi.org/10.1038/nrneurol.2017.122
  26. Tracey I, Johns E. The pain matrix: reloaded or reborn as we image tonic pain using arterial spin labelling. Pain 2010; 148: 359-60. https://doi.org/10.1016/j.pain.2009.11.009
  27. Belanger M, Allaman I, Magistretti PJ. Brain energy metabolism: focus on astrocyte-neuron metabolic cooperation. Cell Metab 2011; 14: 724-38. https://doi.org/10.1016/j.cmet.2011.08.016
  28. Logothetis NK. The underpinnings of the BOLD functional magnetic resonance imaging signal. J Neurosci 2003; 23: 3963-71. https://doi.org/10.1523/JNEUROSCI.23-10-03963.2003
  29. Nguyen T, Potter T, Karmonik C, Grossman R, Zhang Y. Concurrent EEG and functional MRI recording and integration analysis for dynamic cortical activity imaging. J Vis Exp 2018; 136: 56417.
  30. Seeber M, Cantonas LM, Hoevels M, Sesia T, Visser-Vandewalle V, Michel CM. Subcortical electrophysiological activity is detectable with high-density EEG source imaging. Nat Commun 2019; 10: 753. https://doi.org/10.1038/s41467-019-08725-w
  31. Ramon C, Schimpf PH, Haueisen J. Influence of head models on EEG simulations and inverse source localizations. Biomed Eng Online 2006; 5: 10. https://doi.org/10.1186/1475-925X-5-10
  32. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561-71. https://doi.org/10.1001/archpsyc.1961.01710120031004
  33. Kwon OY, Park SP. Frequency of affective symptoms and their psychosocial impact in Korean people with epilepsy: a survey at two tertiary care hospitals. Epilepsy Behav 2013; 26: 51-6. https://doi.org/10.1016/j.yebeh.2012.10.020
  34. Rhee MK, Lee YH, Park SH, Sohn CH, Chung YC, Hong SK, et al. A standardization study of Beck Depression Inventory 1 - Korean version (K-BDI): reliability and factor analysis. Korean J Psychopathol 1995; 4: 77-95.
  35. Cleeland CS, Ladinsky JL, Serlin RC, Nugyen CT. Multidimensional measurement of cancer pain: comparisons of US and Vietnamese patients. J Pain Symptom Manage 1988; 3: 23-7. https://doi.org/10.1016/0885-3924(88)90134-0
  36. Cleeland C. Research in cancer pain. What we know and what we need to know. Cancer 1991; 67(3 Suppl): 823-7. https://doi.org/10.1002/1097-0142(19910201)67:3+<823::AID-CNCR2820671412>3.0.CO;2-S
  37. Yun YH, Mendoza TR, Heo DS, Yoo T, Heo BY, Park HA, et al. Development of a cancer pain assessment tool in Korea: a validation study of a Korean version of the brief pain inventory. Oncology 2004; 66: 439-44. https://doi.org/10.1159/000079497
  38. Pascual-Marqui RD. Standardized low-resolution brain electromagnetic tomography (sLORETA): technical details. Methods Find Exp Clin Pharmacol 2002; 24 Suppl D: 5-12.
  39. R Core Team. R: a language and environment for statistical computing [Internet]. Vienna: R Foundation for Statistical Computing; 2020. Available at: https://www.R-project.org/.
  40. SimicG, Hof PR. In search of the definitive Brodmann's map of cortical areas in human. J Comp Neurol 2015; 523: 5-14. https://doi.org/10.1002/cne.23636
  41. Kragel PA, Kano M, Van Oudenhove L, Ly HG, Dupont P, Rubio A, et al. Generalizable representations of pain, cognitive control, and negative emotion in medial frontal cortex. Nat Neurosci 2018; 21: 283-9. https://doi.org/10.1038/s41593-017-0051-7
  42. Zhang Y, Yu T, Qin B, Li Y, Song G, Yu B. Microstructural abnormalities in gray matter of patients with postherpetic neuralgia: a diffusional kurtosis imaging study. Pain Physician 2016; 19: E601-11.
  43. Jiang L, Zuo XN. Regional homogeneity: a multimodal, multiscale neuroimaging marker of the human connectome. Neuroscientist 2016; 22: 486-505. https://doi.org/10.1177/1073858415595004
  44. Zhang Y, Cao S, Yuan J, Song G, Yu T, Liang X. Functional and structural changes in postherpetic neuralgia brain before and six months after pain relieving. J Pain Res 2020; 13: 909-18. https://doi.org/10.2147/JPR.S246745
  45. Koles ZJ. Trends in EEG source localization. Electroencephalogr Clin Neurophysiol 1998; 106: 127-37. https://doi.org/10.1016/S0013-4694(97)00115-6
  46. Sharma P, Seeck M, Beniczky S. Accuracy of interictal and ictal electric and magnetic source imaging: a systematic review and meta-analysis. Front Neurol 2019; 10: 1250. https://doi.org/10.3389/fneur.2019.01250