Alterations in brain structure and function in patients with osteonecrosis of the femoral head: a multimodal MRI study

Jie Ma; Jia-Jia Wu; Xu-Yun Hua; Mou-Xiong Zheng; Bei-Bei Huo; Xiang-Xin Xing; Sheng-Yi Feng; Bo Li; Jianguang Xu

doi:10.7717/peerj.11759

Alterations in brain structure and function in patients with osteonecrosis of the femoral head: a multimodal MRI study

PeerJ. 2021 Aug 20:9:e11759. doi: 10.7717/peerj.11759. eCollection 2021.

Authors

Jie Ma^#¹, Jia-Jia Wu^#², Xu-Yun Hua^{3

4}, Mou-Xiong Zheng⁴, Bei-Bei Huo¹, Xiang-Xin Xing¹, Sheng-Yi Feng⁴, Bo Li⁴, Jianguang Xu¹

Affiliations

¹ School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
² Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
³ Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University, Shanghai, China.
⁴ Department of Traumatology and Orthopedics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

^# Contributed equally.

Abstract

Background: Pain, a major symptom of osteonecrosis of the femoral head (ONFH), is a complex sensory and emotional experience that presents therapeutic challenges. Pain can cause neuroplastic changes at the cortical level, leading to central sensitization and difficulties with curative treatments; however, whether changes in structural and functional plasticity occur in patients with ONFH remains unclear.

Methods: A total of 23 ONFH inpatients who did not undergo surgery (14 males, nine females; aged 55.61 ± 13.79 years) and 20 controls (12 males, eight females; aged 47.25 ± 19.35 years) were enrolled. Functional indices of the amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and a structural index of tract-based spatial statistics (TBSS) were calculated for each participant. The probability distribution of fiber direction was determined according to the ALFF results.

Results: ONFH patients demonstrated increased ALFF in the bilateral dorsolateral superior frontal gyrus, right medial superior frontal gyrus, right middle frontal gyrus, and right supplementary motor area. In contrast, ONFH patients showed decreased ReHo in the left superior parietal gyrus and right inferior temporal gyrus. There were no significant differences in TBSS or probabilistic tractography.

Conclusion: These results indicate cerebral pain processing in ONFH patients. It is advantageous to use functional magnetic resonance imaging to better understand pain pathogenesis and identify new therapeutic targets in ONFH patients.

Keywords: Diffusion tensor imaging; Functional magnetic resonance imaging; Functional plasticity; Osteonecrosis of the femoral head; Pain.

Grants and funding

This work was supported by the National Key R&D Program of China (Grant No. 2018YFC2001600), the National Natural Science Foundation of China (Grant Nos.: 81802249, 81871836), the Shanghai Science and Technology Committee (Grant Nos.: 18511108300, 18441903903900 and 18441903800), the Three-Year Action Plan for Traditional Chinese Medicine Development from Shanghai Municipal Health Commission (Grant No.: ZY(2018-2020)-ZWB-1001-CPJS49; ZY(2018-2020)-RCPY-3007), the Traditional Chinese Medicine Diagnosis and Treatment Technology Improvement Project from Shanghai Municipal Commission of Health and Family Planning (Grant No.: Zyjx-2017006), and the special project of Postgraduate Innovation Training (A1-GY20-204-0107). The funders had no role in study design, data collection and the analysis, decision to publish, or preparation of the manuscript.