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Modulatory effects of different exercise modalities on the functional connectivity of the periaqueductal grey and ventral tegmental area in patients with knee osteoarthritis: a randomised multimodal magnetic resonance imaging study
- Source :
- British Journal of Anaesthesia. 123:506-518
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Background Knee osteoarthritis is a prevalent disorder with unsatisfactory treatment options. Both physical and mindful exercises may be able to relieve its pain symptoms. We compared the modulatory effects of different exercise modalities on the periaqueductal grey (PAG) and ventral tegmental area (VTA), which play important roles in descending opioidergic pathways and reward/motivation systems in patients with knee osteoarthritis. Methods We recruited and randomised 140 patients into Tai Chi, Baduanjin, stationary cycling, and health education control groups for 12 weeks. Knee injury and Osteoarthritis Outcome Score (KOOS), functional and structural MRI, and blood biomarkers were measured at the beginning and end of the experiment. We used the PAG and VTA as seeds in resting-state functional connectivity (rsFC) analysis. Results Compared with the control group: (i) all exercises significantly increased KOOS pain sub-scores (pain reduction) and serum programmed death 1 (PD-1) concentrations; (ii) all exercises decreased right PAG rsFC with the medial orbital prefrontal cortex, and the decreased rsFC was associated with improvements in knee pain; and (iii) grey matter volume in the medial orbital prefrontal cortex was significantly increased in all exercise groups. There was also significantly decreased rsFC between the left VTA and the medial orbital prefrontal cortex in the Tai Chi and Baduanjin groups. Conclusions Exercise can simultaneously modulate the rsFC of the descending opioidergic pathway and reward/motivation system and blood inflammation markers. Elucidating the shared and unique mechanisms of different exercise modalities may facilitate the development of exercise-based interventions for chronic pain. Clinical trial registration ChiCTR-IOR-16009308.
- Subjects :
- Adult
Male
medicine.medical_specialty
Osteoarthritis
Grey matter
03 medical and health sciences
0302 clinical medicine
Physical medicine and rehabilitation
030202 anesthesiology
Neural Pathways
medicine
Humans
Periaqueductal Gray
Aged
Opioidergic
medicine.diagnostic_test
business.industry
Ventral Tegmental Area
Chronic pain
Magnetic resonance imaging
Middle Aged
Osteoarthritis, Knee
medicine.disease
Magnetic Resonance Imaging
Exercise Therapy
Ventral tegmental area
Clinical trial
Anesthesiology and Pain Medicine
medicine.anatomical_structure
Knee pain
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 00070912
- Volume :
- 123
- Database :
- OpenAIRE
- Journal :
- British Journal of Anaesthesia
- Accession number :
- edsair.doi.dedup.....645c736da88c81bad9dbc0118ee8c521