Brain effect mechanism of lever positioning manipulation on LDH analgesia based on multimodal MRI: a study protocol.

INTRODUCTION: The clinical symptoms of Lumbar Disc Herniation (LDH) can be effectively ameliorated through Lever Positioning Manipulation (LPM), which is closely linked to the brain's pain-regulating mechanisms. Magnetic Resonance Imaging (MRI) offers an objective and visual means to study how the brain orchestrates the characteristics of analgesic effects. From the perspective of multimodal MRI, we applied functional MRI (fMRI) and Magnetic Resonance Spectrum (MRS) techniques to comprehensively evaluate the characteristics of the effects of LPM on the brain region of LDH from the aspects of brain structure, brain function and brain metabolism. This multimodal MRI technique provides a biological basis for the clinical application of LPM in LDH. METHODS AND ANALYSIS: A total of 60 LDH patients and 30 healthy controls, matched by gender, age, and years of education, will be enrolled in this study. The LDH patients will be divided into two groups (Group 1, n = 30; Group 2, n = 30) using a random number table method. Group 1 will receive LPM treatment once every two days, for a total of 12 times over 4 weeks. Group 2 will receive sham LPM treatment during the same period as Group 1. All 30 healthy controls will be divided into Group 3. Multimodal MRI will be performed on Group 1 and Group 2 at three time points (TPs): before LPM (TP1), after one LPM session (TP2), and after a full course of LPM treatment. The healthy controls (Group 3) will not undergo LPM and will be subject to only a single multimodal MRI scan. Participants in both Group 1 and Group 2 will be required to complete clinical questionnaires. These assessments will focus on pain intensity and functional disorders, using the Visual Analog Scale (VAS) and the Japanese Orthopaedic Association (JOA) scoring systems, respectively. DISCUSSION: The purpose of this study is to investigate the multimodal brain response characteristics of LDH patients after treatment with LPM, with the goal of providing a biological basis for clinical applications. TRIAL REGISTRATION NUMBER: https://clinicaltrials.gov/ct2/show/NCT05613179 , identifier: NCT05613179.

Interface coupling and charge doping in graphene on ferroelectric BiAlO3(0001) polar surfaces.

The ferroelectric field-effect transistors (FeFETs) based on graphene/ferroelectric (Gr/FE) hybrid systems have been attracting a lot of attention in recent years. The interface interaction and charge transfer between graphene and the ferroelectric substrates are important factors that determine the performance of graphene-based FeFETs. According to our intuitive sense, the electrostatically doped carriers in graphene on the ferroelectric positive and negative surfaces should be n-type and p-type, respectively. In the present work, however, by employing first-principles density functional theory (DFT) calculations, we reveal that an unusual charge doping effect occurs in graphene on the thermodynamically preferred ferroelectric BiAlO3(0001) polar surfaces. The graphene on the BiAlO3(0001) positive surface is electrostatically doped p-type, while the BiAlO3(0001) negative surface induces n-type carriers in the graphene overlayer. Further analysis demonstrates that, although the electrostatic doping effect in the Gr/FE system depends on the polarization direction of the ferroelectric substrate, the resultant carrier type and density in graphene are determined by the specific band arrangement between graphene and the ferroelectric polar surface. In addition to the graphene-based FeFETs, our results predict that the Gr/BiAlO3(0001) systems can be used to fabricate graphene p-n homojunctions by engineering the domain pattern in the ferroelectric substrate.