Different exercise modalities relieve pain syndrome in patients with knee osteoarthritis and modulate the dorsolateral prefrontal cortex: A multiple mode MRI study.

Published on Nov 1, 2019in Brain Behavior and Immunity6.17
· DOI :10.1016/j.bbi.2019.08.193
Jiao Liu7
Estimated H-index: 7
(FJUTCM: Fujian University of Traditional Chinese Medicine),
Lidian Chen22
Estimated H-index: 22
(FJUTCM: Fujian University of Traditional Chinese Medicine)
+ 15 AuthorsJian Kong45
Estimated H-index: 45
(Harvard University)
Abstract Objectives Knee osteoarthritis (KOA) is a common degenerative joint disease with no satisfactory intervention. Recently, both physical and mindfulness exercises have received considerable attention for their implications in KOA pain management, and the dorsolateral prefrontal cortex (DLPFC) has displayed a critical role in pain modulation. This study aimed to comparatively investigate the modulation effects of different exercises using multidisciplinary measurements. Methods 140 KOA patients were randomized into Tai Chi, Baduanjin, stationary cycling, or health education control groups for 12 weeks. Knee Injury and Osteoarthritis Outcome Score (KOOS), resting state functional magnetic resonance imaging (fMRI), structural MRI, and serum biomarkers were measured at baseline and at the end of the study. Results We found: 1) increased KOOS pain subscores (pain reduction) and serum programmed cell death protein 1 (PD-1) levels in the three exercise groups compared to the control group; 2) decreased resting state functional connectivity (rsFC) of the DLPFC-supplementary motor area (SMA) and increased rsFC between the DLPFC and anterior cingulate cortex in all exercise groups compared to the control group; 3) significant associations between DLPFC-SMA rsFC with KOOS pain subscores and serum PD-1 levels at baseline; 4) significantly increased grey matter volume in the SMA in the Tai Chi and stationary cycling groups, and a trend toward significant increase in the Baduanjin group compared to the control group; 5) significant DLPFC rsFC differences among different exercise groups; and 6) that baseline DLPFC-SMA rsFC can predict the effect of mind-body exercise on pain improvement in KOA. Conclusion Our results suggest that different exercises can modulate both common and unique DLPFC (cognitive control) pathways, and altered DLPFC-SMA rsFC is associated with serum biomarker levels. Our findings also highlight the potentials of neuroimaging biomarkers in predicting the therapeutic effect of mind-body exercises on KOA pain.
  • References (73)
  • Citations (1)
📖 Papers frequently viewed together
1 Citations
11 Citations
5 Authors (Xiaoyan Chen, ..., Jian Kong)
35 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
#1Jiao Liu (FJUTCM: Fujian University of Traditional Chinese Medicine)H-Index: 7
#2Lidian Chen (FJUTCM: Fujian University of Traditional Chinese Medicine)H-Index: 22
Last. Jian Kong (Harvard University)H-Index: 45
view all 18 authors...
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 ...
4 CitationsSource
#1Jin Cao (Beijing University of Chinese Medicine)H-Index: 2
#2Yiheng Tu (Harvard University)H-Index: 7
Last. Jian Kong (Harvard University)H-Index: 45
view all 9 authors...
2 CitationsSource
#1Liye ZouH-Index: 13
#2Yanjie ZhangH-Index: 4
Last. Hong LiH-Index: 2
view all 10 authors...
Background: Chronic low back pain (CLBP) is a common health issue worldwide. Tai Chi, Qigong, and Yoga, as the most widely practiced mindful exercises, have promising effects for CLBP-specific symptoms. Objective: We therefore conducted a comprehensive review investigating the effects of mindful exercises versus active and/or non-active controls while evaluating the safety and pain-related effects of mindful exercises in adults with CLBP. Methods: We searched five databases (MEDLINE, EMBASE, SCO...
3 CitationsSource
#1Jian Kong (Harvard University)H-Index: 45
#2Emily Wolcott (Tufts University)H-Index: 1
Last. Chenchen Wang (Tufts University)H-Index: 21
view all 8 authors...
This study examines altered resting state functional connectivity (rsFC) of the cognitive control network (CCN) in fibromyalgia patients as compared to healthy controls, as well as how an effective mind-body intervention, Tai Chi, can modulate the altered rsFC of the CCN. Patients with fibromyalgia and matched healthy subjects were recruited in this study. Fibromyalgia patients were scanned 12 weeks before and after intervention. The bilateral dorsolateral prefrontal cortex (DLPFC) was used as a...
7 CitationsSource
#1Jiao Liu (FJUTCM: Fujian University of Traditional Chinese Medicine)H-Index: 7
#2Jing Tao (FJUTCM: Fujian University of Traditional Chinese Medicine)H-Index: 20
Last. Jian Kong (Harvard University)H-Index: 45
view all 14 authors...
7 CitationsSource
#1Wei-Yi Ong (NUS: National University of Singapore)H-Index: 37
#2Christian S. Stohler (Columbia University)H-Index: 7
Last. Deron R. Herr (NUS: National University of Singapore)H-Index: 20
view all 3 authors...
The prefrontal cortex (PFC) is not only important in executive functions, but also pain processing. The latter is dependent on its connections to other areas of the cerebral neocortex, hippocampus, periaqueductal gray (PAG), thalamus, amygdala, and basal nuclei. Changes in neurotransmitters, gene expression, glial cells, and neuroinflammation occur in the PFC during acute and chronic pain, that result in alterations to its structure, activity, and connectivity. The medial PFC (mPFC) could serve ...
18 CitationsSource
#1Yiheng Tu (Harvard University)H-Index: 7
#2Ana Ortiz (Harvard University)H-Index: 3
Last. Jian Kong (Harvard University)H-Index: 45
view all 16 authors...
Abstract Despite the high prevalence and socioeconomic impact of chronic low back pain (cLBP), treatments for cLBP are often unsatisfactory, and effectiveness varies widely across patients. Recent neuroimaging studies have demonstrated abnormal resting-state functional connectivity (rsFC) of the default mode, salience, central executive, and sensorimotor networks in chronic pain patients, but their role as predictors of treatment responsiveness has not yet been explored. In this study, we used m...
1 CitationsSource
#1Yiheng Tu (Harvard University)H-Index: 7
#2Joel Park (Harvard University)H-Index: 7
Last. Jian Kong (Harvard University)H-Index: 45
view all 8 authors...
Abstract Classical theories suggest placebo analgesia and nocebo hyperalgesia are based on expectation and conditioned experience. Whereas the neural mechanism of how expectation modulates placebo and nocebo effects during pain anticipation have been extensively studied, little is known about how experience may change brain networks to produce placebo and nocebo responses. We investigated the neural pathways of direct and observational conditioning for conscious and nonconscious conditioned plac...
4 CitationsSource
#1Louise Urien (NYU: New York University)H-Index: 3
#2Zhengdong Xiao (NYU: New York University)H-Index: 3
Last. Jing Wang (NYU: New York University)H-Index: 10
view all 6 authors...
Pain is a complex sensory and affective experience. Through its anticipation, animals can learn to avoid pain. Much is known about passive avoidance during a painful event; however, less is known about active pain avoidance. The anterior cingulate cortex (ACC) is a critical hub for affective pain processing. However, there is currently no mechanism that links ACC activities at the cellular level with behavioral anticipation or avoidance. Here we asked whether distinct populations of neurons in t...
6 CitationsSource
#1Guilin Huang (Xi'an Jiaotong University)H-Index: 1
#2Sha HuaH-Index: 1
Last. Xiujin Chen (Xi'an Jiaotong University)H-Index: 1
view all 6 authors...
9 CitationsSource
Cited By1
#1Xiaorong Chen (SZU: Shenzhen University)
#2Jiabao Cui (SCNU: South China Normal University)
Last. Albert Yeung (Harvard University)H-Index: 25
view all 7 authors...
Dao Yin is a form of exercise combining physical movements, mental focus, and breathing originated in ancient China. In this review, we introduce the history in the development and the scope of Dao Yin, the relationship between Dao Yin with Taoist culture and Qigong, and the potential mechanisms of how Dao Yin promotes health and alleviate illnesses. Empirical research studies using Dao Yin for treatment of lumbar spondylosis, peripheral musculoskeletal diseases, cervical spondylosis, heart dise...