ABSTRACT
BACKGROUND: Resting-state functional magnetic resonance imaging (rs-fMRI) can evaluate brain functional connectivity without requiring subjects to perform a specific task. This rs-fMRI is very useful in patients with cognitive decline or unable to respond to tasks. However, long scan durations have been suggested to measure connectivity between brain areas to produce more reliable results, which are not clinically optimal. Therefore, this study aims to evaluate a shorter scan duration and compare the scan duration of 10 and 15 min using the rs-fMRI approach. METHODS: Twenty-one healthy male and female participants (seventeen right-handed and four left-handed), with ages ranging between 21 and 60 years, were recruited. All participants underwent both 10 and 15 min of rs-fMRI scans. The present study evaluated the default mode network (DMN) areas for both scan durations. The areas involved were the posterior cingulate cortex (PCC), medial prefrontal cortex (mPFC), left inferior parietal cortex (LIPC), and right inferior parietal cortex (RIPC). Fifteen causal models were constructed and inverted using spectral dynamic causal modelling (spDCM). The models were compared using Bayesian Model Selection (BMS) for group studies. RESULT: The BMS results indicated that the fully connected model was the winning model among 15 competing models for both 10 and 15 min scan durations. However, there was no significant difference in effective connectivity among the regions of interest between the 10 and 15 min scans. CONCLUSION: Scan duration in the range of 10 to 15 min is sufficient to evaluate the effective connectivity within the DMN region. In frail subjects, a shorter scan duration is more favourable.
ABSTRACT
Interventional Pain Procedures (IPPs) is a relatively new treatment modality for chronic pain in Malaysia. The Interventional Pain Service (IPS) newly set up in our institution is led by a pain neurosurgeon and provides a whole package of multimodal pain management including different range of IPPs. This clinical audit is to examine the quality of IPPs performed within the IPS in our institution since its initiation. A total of 87 IPPs were performed on 56 chronic pain patients over 3-year duration. As high as 81.8% of the procedures were effective and 81.5% of patients were satisfied. Only one minor transient complication occurred after an intradiscal procedure but none resulted in death or permanent disability. Thus, safe and effective IPPs can be provided as part of IPS in a local neurosurgical pain centre to bring more comprehensive and less fragmented care for chronic pain patients.
