Abstract
Background: Chronic shoulder pain (CSP) is one of the most common health problems associated with dysfunction and persistent pain. Emerging evidence suggested that abnormalities in central nervous system play a role in the condition.
Purpose: The aim of this study is to systematically review the structural and functional brain alterations in people with CSP.
Method: Electronic database of PubMed, MEDLINE, Web of Science and CINAHL were systematically searched from inception to February 2024. Studies that investigated adults with CSP and compared structural and functional brain changes were included. Quality of evidence was assessed using GRADE approach and the risk of bias was evaluated through the Newcastle Ottawa scale (NOS) by 2 independent researchers.
Results: Of the 28 relevant studies, 12 studies were included in the final analysis. 5 studies evaluated grey matter volume (GMV) changes, of which 4 reported GMV reduction in thalamus, temporal gyrus, hippocampus, superior frontal gyrus, prefrontal cortex and insula. There is conflicting evidence of changes in cortical thickness and sulcal depth in people with chronic shoulder pain. Functional organisations were assessed in 8 studies, with 5 studies identifying alteration in functional connectivity. The visual network exhibited decreased functional connectivity and increase functional connectivity in postcentral gyrus, cingulate cortex, periaqueductal gray and somatosensory cortex. 2 studies reported reduction of Regional Homogeneity (Reho) in medial cingulate cortex. Alterations of amplitude of low-frequency fluctuation and cerebral blood flow was evident in regions of the default mode network.
Conclusion: Overall, there is low to moderate evidence suggesting regional grey matter changes, altered functional connectivity and cerebrovascular changes in CSP. These findings may contribute to our understanding in the chronification of musculoskeletal pain and act as potential biomarkers in identifying and treating CSP. Further longitudinal research is warranted to confirm the current findings.
Purpose: The aim of this study is to systematically review the structural and functional brain alterations in people with CSP.
Method: Electronic database of PubMed, MEDLINE, Web of Science and CINAHL were systematically searched from inception to February 2024. Studies that investigated adults with CSP and compared structural and functional brain changes were included. Quality of evidence was assessed using GRADE approach and the risk of bias was evaluated through the Newcastle Ottawa scale (NOS) by 2 independent researchers.
Results: Of the 28 relevant studies, 12 studies were included in the final analysis. 5 studies evaluated grey matter volume (GMV) changes, of which 4 reported GMV reduction in thalamus, temporal gyrus, hippocampus, superior frontal gyrus, prefrontal cortex and insula. There is conflicting evidence of changes in cortical thickness and sulcal depth in people with chronic shoulder pain. Functional organisations were assessed in 8 studies, with 5 studies identifying alteration in functional connectivity. The visual network exhibited decreased functional connectivity and increase functional connectivity in postcentral gyrus, cingulate cortex, periaqueductal gray and somatosensory cortex. 2 studies reported reduction of Regional Homogeneity (Reho) in medial cingulate cortex. Alterations of amplitude of low-frequency fluctuation and cerebral blood flow was evident in regions of the default mode network.
Conclusion: Overall, there is low to moderate evidence suggesting regional grey matter changes, altered functional connectivity and cerebrovascular changes in CSP. These findings may contribute to our understanding in the chronification of musculoskeletal pain and act as potential biomarkers in identifying and treating CSP. Further longitudinal research is warranted to confirm the current findings.
| Original language | English |
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| Publication status | Not published / presented only - Sept 2024 |
| Event | World Physiotherapy - Asia Western Pacific Congress 2024 - Bali, Indonesia Duration: 27 Sept 2024 → 28 Sept 2024 https://world.physio/regions/asia-western-pacific |
Congress
| Congress | World Physiotherapy - Asia Western Pacific Congress 2024 |
|---|---|
| Country/Territory | Indonesia |
| City | Bali |
| Period | 27/09/24 → 28/09/24 |
| Internet address |