Effect of Chinese tuina massage therapy on resting state brain functional network of patients with chronic neck pain

Objective:Cervical disease,a type of chronic pain,can greatly impact quality of life.Traditional Chinese tuina,a form of therapeutic massage and manipulation,has been shown to be effective in relieving pain and other symptoms in patients with chronic neck pain.This study applied functional magnetic resonance imaging (fMRI) to explore the features of the resting state network of patients with chronic neck pain caused by cervical radiculopathy,and how tuina affects the causality between intrinsic brain networks.Methods:Using Granger causality analysis,effective connectivity of brain networks of 10 patients with chronic neck pain was compared with 10 healthy control subjects.Resting state fMRI data were using magnetic resonance scanning.Cervical spondylosis symptom scores were evaluated before and after 4 weeks of tuina therapy.Independent component analysis was applied to extract the specific networks related to sensation,execution,and cognition,including sensorimotor network (SMN),visual network (VN),auditory network (AN),anterior and posterior default mode network (aDMN,pDMN),left frontoparietal network and right frontoparietal network.Results:Compared with the control group,data from the treatment group revealed two major findings:before tuina therapy,SMN had a profound influence on aDMN and AN greatly affected pDMN;however,after 4 weeks of tuina therapy,aDMN and SMN showed reversed causality.Conclusion:Chronic neck pain caused by cervical radiculopathy may influence the DMN,which plays an important role in emotion,cognition,and memory,by stimulating the sensory afferent network.Tuina not only significantly relieves pain and discomfort,but also reverses the causality between aDMN and SMN.

Age-related changes in resting-state functional connectivity in older adults

Age-related changes in the brain connectivity of healthy older adults have been widely studied in recent years,with some differences in the obtained results.Most of these studies showed decreases in general functional connectivity,but they also found increases in some particular regions and areas.Frequently,these studies compared young individuals with older subjects,but few studies compared different age groups only in older populations.The purpose of this study is to analyze whole-brain functional connectivity in healthy older adult groups and its network characteristics through functional segregation.A total of 114 individuals,48 to 89 years old,were scanned using resting-state functional magnetic resonance imaging in a resting state paradigm and were divided into six different age groups(<60,60–64,65–69,70–74,75–79,≥80 years old).A partial correlation analysis,a pooled correlation analysis and a study of 3-cycle regions with prominent connectivity were conducted.Our results showed progressive diminution in the functional connectivity among different age groups and this was particularly pronounced between 75 and 79 years old.The oldest group(≥80 years old)showed a slight increase in functional connectivity compared to the other groups.This occurred possibly because of compensatory mechanism in brain functioning.This study provides information on the brain functional characteristics of every age group,with more specific information on the functional progressive decline,and supplies methodological tools to study functional connectivity characteristics.Approval for the study was obtained from the ethics committee of the Comision de Bioetica de la Universidad de Barcelona(approval No.PSI2012-38257)on June 5,2012,and from the ethics committee of the Barcelona’s Hospital Clinic(approval No.2009-5306 and 2011-6604)on October 22,2009 and April 7,2011 respectively.