Altered brain functional activity and connectivity in bone metastasis pain of lung cancer patients: A preliminary resting-state fMRI study

Abstract

Bone metastasis pain (BMP) is one of the most prevalent symptoms among cancer survivors. The present study aims to explore the brain functional activity and connectivity patterns in BMP of lung cancer patients preliminarily. Thirty BMP patients and 33 healthy controls (HCs) matched for age and sex were recruited from inpatients and communities, respectively. All participants underwent fMRI data acquisition and pain assessment. Low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) were applied to evaluate brain functional activity. Then, functional connectivity (FC) was calculated for the ALFF- and ReHo-identified seed brain regions. A two-sample t-test or Manny–Whitney U-test was applied to compare demographic and neuropsychological data as well as the neuroimaging indices according to the data distribution. A correlation analysis was conducted to explore the potential relationships between neuroimaging indices and pain intensity. Receiver operating characteristic curve analysis was applied to assess the classification performance of neuroimaging indices in discriminating individual subjects between the BMP patients and HCs. No significant intergroup differences in demographic and neuropsychological data were noted. BMP patients showed reduced ALFF and ReHo largely in the prefrontal cortex and increased ReHo in the bilateral thalamus and left fusiform gyrus. The lower FC was found within the prefrontal cortex. No significant correlation between the neuroimaging indices and pain intensity was observed. The neuroimaging indices showed satisfactory classification performance between the BMP patients and HCs, and the combined ALFF and ReHo showed a better accuracy rate (93.7%) than individual indices. In conclusion, altered brain functional activity and connectivity in the prefrontal cortex, fusiform gyrus, and thalamus may be associated with the neuropathology of BMP and may represent a potential biomarker for classifying BMP patients and healthy controls.

Altered gray matter volume and functional connectivity in lung cancer patients with bone metastasis pain

“…Functional coherence between the MTG and cerebellum_8 may be involved in the experience of emotion, control, and coordination of cognitive and appropriate behavioral responses in individuals with BMP. However, these findings are not consistent with our previous studies (Liu et al, 2022; Zhou et al, 2022), which demonstrated that BMP was associated with alterations of brain activity and FC in some pain‐related brain regions such as prefrontal cortex and thalamus (Liu et al, 2022). These differences in results may be potentially attributed to factors such as sample size, study design, and heterogeneity of population characteristics and study methodology.…”

“…Recently, our group revealed altered brain activity and functional connectivity (FC) in lung cancer patients with BMP in specific regions, including the prefrontal cortex, thalamus, and amygdala (Liu et al, 2022; Zhou et al, 2022). While these results provide an important preliminary view of the neurophysiologic mechanisms underlying BMP, the potential effect of BMP on cerebral structure and function, particularly gray matter volume (GMV) and related functional networks, have not yet been adequately and clearly illustrated.…”