Abnormal Anatomical and Functional Connectivity of the Thalamo-sensorimotor Circuit in Chronic Low Back Pain: Resting-state Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging Study.

Thalamocortical dysfunction is thought to underlie the pathophysiology of chronic pain revealed by electroencephalographic studies. The thalamus serves as a primary relay center to transmit sensory information and motor impulses via dense connections with the somatosensory and motor cortex. In this study, diffusion tensor imaging (DTI) (probabilistic tractography) and resting-state functional magnetic resonance imaging (functional connectivity) were used to characterize the anatomical and functional integrity of the thalamo-sensorimotor pathway in chronic low back pain (cLBP). Fifty-four patients with cLBP and 54 healthy controls were included. The results suggested significantly increased anatomical connectivity of the left thalamo-motor pathway characterized by probabilistic tractography in patients with cLBP. Moreover, there was significantly altered resting-state functional connectivity (rsFC) of bilateral thalamo-motor/somatosensory pathways in patients with cLBP as compared to healthy controls. We also detected a significant correlation between pain intensity during the MRI scan and rsFC of the right thalamo-somatosensory pathway in cLBP. Our findings highlight the involvement of the thalamo-sensorimotor circuit in the pathophysiology of cLBP.

Neuroimaging-Based Scalp Acupuncture Locations for Dementia.

Scalp acupuncture is a modality of acupuncture in which acupuncture needles are inserted into a certain layer of the scalp in order to affect the function of corresponding areas of the cerebral cortex and relieve symptoms. Clinical studies have demonstrated the potential of scalp acupuncture as a non-pharmacological treatment for dementia. Unfortunately, recent findings from brain neuroimaging studies on dementia have not been incorporated into scalp acupuncture. This study aims to integrate meta-analysis, resting-state functional connectivity, and diffusion tensor imaging (DTI) to identify potential locations of scalp acupuncture for treatment of dementia. We found that the prefrontal cortex, the medial prefrontal cortex, the middle and superior temporal gyrus, the temporal pole, the supplementary motor area, the inferior occipital gyrus, and the precuneus are involved in the pathophysiology of dementia and, therefore, may be the target areas of scalp acupuncture for dementia treatment. The neuroimaging-based scalp acupuncture protocol developed in this study may help to refine the locations for the treatment of dementia. Integrating multidisciplinary methods to identify key surface cortical areas associated with a certain disorder may shed light on the development of scalp acupuncture and other neuromodulation methods such as transcranial electrical current stimulation, particularly in the domain of identifying stimulation locations.