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      Deficits in the thalamocortical pathway associated with hypersensitivity to pain in patients with frozen shoulder

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          Abstract

          Background and purpose

          Frozen shoulder (FS) is a chronic pain condition and has been shown to be associated with pain sensitization. However, the underyling brain mechanisms remain unclear. Here, we aimed to explore brain alterations and their association with pain sensitization in patients with FS.

          Materials and methods

          A total of 54 FS patients and 52 healthy controls (HCs) were included in this study. Here, we applied both structural and functional magnetic resonance imaging (MRI) techniques to investigate brain abnormalities in FS patients. Voxel-wise comparisons were performed to reveal the differences in the gray matter volume (GMV) and amplitude of low-frequency fluctuation (ALFF) between FS patients and HCs. Furthermore, the region of interest (ROI) to whole-brain functional connectivity (FC) was calculated and compared between groups. Finally, Pearson's correlation coefficients were computed to reveal the association between clinical data and brain alterations.

          Results

          Four main findings were observed: (1) FS patients exhibited decreased thalamus GMV, which correlated with pain intensity and pain threshold; (2) relative to HCs, FS patients exhibited a higher level of ALFF within the anterior cingulate cortex (ACC) and the thalamus; (3) FS patients exhibited a significant increase in Tha-S1 FC compared to HCs; and (4) the effect of thalamus GMV on pain intensity was mediated by pain threshold in FS patients.

          Conclusion

          The dysfunctional thalamus might induce pain hypersensitivity, which further aggravates the pain in FS patients.

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          Most cited references53

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          The Link between Depression and Chronic Pain: Neural Mechanisms in the Brain

          Chronic pain, as a stress state, is one of the critical factors for determining depression, and their coexistence tends to further aggravate the severity of both disorders. Unfortunately, their association remains unclear, which creates a bottleneck problem for managing chronic pain-induced depression. In recent years, studies have found considerable overlaps between pain- and depression-induced neuroplasticity changes and neurobiological mechanism changes. Such overlaps are vital to facilitating the occurrence and development of chronic pain and chronic pain-induced depression. In this review, we summarized the role of neuroplasticity in the occurrence and development of the two disorders in question and explored individualized application strategies of analgesic drugs and antidepressants that have different pharmacological effects in the treatment of chronic pain-induced depression. Therefore, this review may provide new insights into the understanding of association between chronic pain and depression.
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            Chronic Pain: Structural and Functional Changes in Brain Structures and Associated Negative Affective States

            Chronic pain is a condition in which pain progresses from an acute to chronic state and persists beyond the healing process. Chronic pain impairs function and decreases patients’ quality of life. In recent years, efforts have been made to deepen our understanding of chronic pain and to develop better treatments to alleviate chronic pain. In this review, we summarize the results of previous studies, focusing on the mechanisms underlying chronic pain development and the identification of neural areas related to chronic pain. We review the association between chronic pain and negative affective states. Further, we describe the structural and functional changes in brain structures that accompany the chronification of pain and discuss various neurotransmitter families involved. Our review aims to provide guidance for the development of future therapeutic approaches that could be used in the management of chronic pain.
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              Cellular Circuits in the Brain and Their Modulation in Acute and Chronic Pain

              Chronic, pathological pain remains a global health problem and a challenge to basic and clinical sciences. A major obstacle to preventing, treating, or reverting chronic pain has been that the nature of neural circuits underlying the diverse components of the complex, multidimensional experience of pain is not well understood. Moreover, chronic pain involves diverse maladaptive plasticity processes, which have not been decoded mechanistically in terms of involvement of specific circuits and cause-effect relationships. This review aims to discuss recent advances in our understanding of circuit connectivity in the mammalian brain at the level of regional contributions and specific cell types in acute and chronic pain. A major focus is placed on functional dissection of sub-neocortical brain circuits using optogenetics, chemogenetics, and imaging technological tools in rodent models with a view towards decoding sensory, affective, and motivational-cognitive dimensions of pain. The review summarizes recent breakthroughs and insights on structure-function properties in nociceptive circuits and higher order sub-neocortical modulatory circuits involved in aversion, learning, reward, and mood and their modulation by endogenous GABAergic inhibition, noradrenergic, cholinergic, dopaminergic, serotonergic, and peptidergic pathways. The knowledge of neural circuits and their dynamic regulation via functional and structural plasticity will be beneficial towards designing and improving targeted therapies.
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                Author and article information

                Contributors
                Journal
                Front Neurol
                Front Neurol
                Front. Neurol.
                Frontiers in Neurology
                Frontiers Media S.A.
                1664-2295
                17 May 2023
                2023
                : 14
                : 1180873
                Affiliations
                [1] 1Department of Orthopedic Surgery, Tianjin Hospital , Tianjin, China
                [2] 2Department of Orthopedic Surgery, Tianjin Medical University General Hospital , Tianjin, China
                [3] 3Department of Orthopaedics, Honghui Hospital, Xi'an Jiaotong University , Xian, China
                Author notes

                Edited by: Arpad Pardutz, University Szeged, Hungary

                Reviewed by: Jian Jiang, The First Affiliated Hospital of Nanchang University, China; Denggui Fan, University of Science and Technology Beijing, China; Nikoletta Szabó, University of Szeged, Hungary

                *Correspondence: Xu Chu chuxuwork@ 123456163.com

                †These authors have contributed equally to this work

                Article
                10.3389/fneur.2023.1180873
                10229835
                37265462
                a305342e-a52e-49ea-bf01-5e99c557786c
                Copyright © 2023 Li, Li, Zhao, Zhou and Chu.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 06 March 2023
                : 19 April 2023
                Page count
                Figures: 4, Tables: 4, Equations: 0, References: 53, Pages: 9, Words: 6452
                Categories
                Neurology
                Original Research
                Custom metadata
                Headache and Neurogenic Pain

                Neurology
                functional magnetic resonance imaging,chronic pain,frozen shoulder,amplitude of low frequency fluctuation,gray matter volume,functional connectivity

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