Identification of Specific Abnormal Brain Functional Activity and Connectivity in Cancer Pain Patients: A Preliminary Resting-State fMRI Study

Abstract

Yingjie Hua,1,* Yongkang Geng,2,* Surui Liu,3 Shuiwei Xia,4 Yan Liu,3 Sufang Cheng,4 Chunmiao Chen,4 Chunying Pang,2 Zhongwei Zhao,1 Bo Peng,3 Yakang Dai,3 Jiansong Ji,4 Dan Wu1 1Department of Pain Medicine, Zhejiang Key Laboratory of Imaging and Interventional Medicine. The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang Province, People’s Republic of China; 2School of Life Science and Technology, Changchun University of Science and Technology, Changchun, Jilin Province, People’s Republic of China; 3Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu Province, People’s Republic of China; 4Department of Radiology, Zhejiang Key Laboratory of Imaging and Interventional Medicine. The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jiansong Ji; Dan Wu, Email [email protected]; [email protected]: This study investigates the differences in brain functional activity and connectivity patterns between Cancer Pain (CP) patients and Healthy Controls (HCs) using resting-state functional magnetic resonance imaging (rs-fMRI) to identify potential neuroimaging biomarkers.Methods: This study collected rs-fMRI data from 25 CP patients and 25 hCs, processed the functional MRI images, and calculated metrics such as amplitude of low-frequency fluctuation (ALFF), Regional Homogeneity (ReHo), and FC. Through statistical analysis, differences in brain functional activity and connectivity between the cancer pain group and the healthy control group were investigated, followed by machine learning classification.Results: The results showed that compared to the normal group, reductions in the ALFF were primarily observed in the bilateral inferior temporal gyrus; ReHo increased in the right middle temporal gyrus and decreased in the left cerebellum Crus2. Using the statistically different brain areas as seed points to construct FC networks and performing statistical analysis, it was found that the regions with decreased FC connection strength between the cancer pain group and the normal group were mainly in the prefrontal cortex (PFC), the postcentral gyrus of the parietal lobe, and the cerebellum. Statistical results indicated that there was no significant correlation between pain scores (Numeric Rating Scale, NRS) and neuroimaging metrics. According to the machine learning classification, the FC features of the right precentral gyrus achieved higher diagnostic efficacy (AUC = 0.804) compared to ALFF and ReHo in distinguishing between CP patients and HCs.Conclusion: Brain activity and FC in CP patients show abnormalities in regions such as the inferior temporal gyrus, middle temporal gyrus, prefrontal cortex, parietal lobe, and cerebellum. These areas may be interconnected through neural networks and jointly participate in functions related to pain perception, emotion regulation, cognitive processing, and motor control. However, the precise connections and mechanisms of action require further research.Keywords: cancer pain, resting-state fMRI, low-frequency fluctuations, regional homogeneity, functional connectivity

Keywords

• cancer pain
• resting-state fmri
• low-frequency fluctuations
• regional homogeneity
• functional connectivity