Dataset Information

Structural and functional brain changes in people with knee osteoarthritis: a scoping review.

ABSTRACT:

Background

Knee osteoarthritis is a highly prevalent disease worldwide that leads to functional disability and chronic pain. It has been shown that not only changes are generated at the joint level in these individuals, but also neuroplastic changes are produced in different brain areas, especially in those areas related to pain perception, therefore, the objective of this research was to identify and compare the structural and functional brain changes in knee OA versus healthy subjects.

Methodology

Searches in MEDLINE (PubMed), EMBASE, WOS, CINAHL, SCOPUS, Health Source, and Epistemonikos databases were conducted to explore the available evidence on the structural and functional brain changes occurring in people with knee OA. Data were recorded on study characteristics, participant characteristics, and brain assessment techniques. The methodological quality of the studies was analysed with Newcastle Ottawa Scale.

Results

Sixteen studies met the inclusion criteria. A decrease volume of the gray matter in the insular region, parietal lobe, cingulate cortex, hippocampus, visual cortex, temporal lobe, prefrontal cortex, and basal ganglia was found in people with knee OA. However, the opposite occurred in the frontal lobe, nucleus accumbens, amygdala region and somatosensory cortex, where an increase in the gray matter volume was evidenced. Moreover, a decreased connectivity to the frontal lobe from the insula, cingulate cortex, parietal, and temporal areas, and an increase in connectivity from the insula to the prefrontal cortex, subcallosal area, and temporal lobe was shown.

Conclusion

All these findings are suggestive of neuroplastic changes affecting the pain matrix in people with knee OA.

SUBMITTER: Salazar-Mendez J

PROVIDER: S-EPMC10493091 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Structural and functional brain changes in people with knee osteoarthritis: a scoping review.

Salazar-Méndez Joaquín J Cuyul-Vásquez Iván I Viscay-Sanhueza Nelson N Morales-Verdugo Juan J Mendez-Rebolledo Guillermo G Ponce-Fuentes Felipe F Lluch-Girbés Enrique E

PeerJ 20230907

<h4>Background</h4>Knee osteoarthritis is a highly prevalent disease worldwide that leads to functional disability and chronic pain. It has been shown that not only changes are generated at the joint level in these individuals, but also neuroplastic changes are produced in different brain areas, especially in those areas related to pain perception, therefore, the objective of this research was to identify and compare the structural and functional brain changes in knee OA <i>versus</i> healthy su ...[more]

PMID: 37701842

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Project description:ObjectiveTo identify risk factors for pain and functional deterioration in people with knee and hip osteoarthritis (OA) to form the basis of a future 'stratification tool' for OA development or progression.DesignSystematic review and meta-analysis.MethodsAn electronic search of the literature databases, Medline, Embase, CINAHL, and Web of Science (1990-February 2020), was conducted. Studies that identified risk factors for pain and functional deterioration to knee and hip OA were included. Where data and study heterogeneity permitted, meta-analyses presenting mean difference (MD) and ORs with corresponding 95% CIs were undertaken. Where this was not possible, a narrative analysis was undertaken. The Downs & Black tool assessed methodological quality of selected studies before data extraction. Pooled analysis outcomes were assessed and reported using the Grading of Reccomendation, Assessment, Development and Evaluation (GRADE) approach.Results82 studies (41 810 participants) were included. On meta-analysis: there was moderate quality evidence that knee OA pain was associated with factors including: Kellgren and Lawrence≥2 (MD: 2.04, 95% CI 1.48 to 2.81; p<0.01), increasing age (MD: 1.46, 95% CI 0.26 to 2.66; p=0.02) and whole-organ MRI scoring method (WORMS) knee effusion score ≥1 (OR: 1.35, 95% CI 0.99 to 1.83; p=0.05). On narrative analysis: knee OA pain was associated with factors including WORMS meniscal damage ≥1 (OR: 1.83). Predictors of joint pain in hip OA were large acetabular bone marrow lesions (BML; OR: 5.23), chronic widespread pain (OR: 5.02) and large hip BMLs (OR: 4.43).ConclusionsOur study identified risk factors for clinical pain in OA by imaging measures that can assist in predicting and stratifying people with knee/hip OA. A 'stratification tool' combining verified risk factors that we have identified would allow selective stratification based on pain and structural outcomes in OA.Prospero registration numberCRD42018117643.

Project description:BackgroundIn recent years, significant progress in the diagnosis of knee osteoarthritis (OA) has been made due to advancements in imaging techniques, especially magnetic resonance imaging (MRI). However, the diagnostic accuracy of MRI for knee OA lacks agreement in the literature due to limitations such as heterogeneous reference standards and suboptimal methodological assessment tools. This scoping review systematically collated the literature on the accuracy of MRI in diagnosing symptomatic knee OA and evaluated its methodological quality using a novel tool.MethodsA comprehensive search was conducted across seven electronic databases to identify systematic reviews, with or without meta-analyses, published until May 30, 2024. Selected articles were systematic reviews on test accuracy of MRI for knee OA, whose methodological quality was assessed using a tailored version of the A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 tool, and the test accuracy performance summarized.ResultsThe search yielded 8,586 records of which 73 full-text articles were assessed for eligibility. We included 3 systematic reviews with a total of 99 original studies (7,530 participants). The methodological quality assessment of the reviews revealed common deficiencies in research questions and inclusion criteria components (2/3, 66.7%), protocol registration (2/3, 66.7%), use of statistical methods (1/3, 33.3%), and risk of bias assessment (2/3, 66.7%). The reference standards used were histology (1/3, 33.3%), radiography (1/3, 33.3%), computed tomography (1/3, 33.3%), clinical evaluation (1/3, 33.3%) and direct visual inspection (1/3, 33.3%), open surgery (1/3, 33.3%) and arthroscopy (3/3, 100%). In two reviews with meta-analysis the accuracy of MRI was: sensitivity 61% [95% confidence interval (CI), 53-68%] and specificity 82% (95% CI, 77-87%) (low methodological quality); and sensitivity 74% (95% CI, 71-77%) and specificity 95% (95% CI, 94-95%) (high methodological quality). In the third systematic review, without meta-analysis, the MRI sensitivity and specificity ranged from 26% to 96% and from 50% to 100%, respectively (critically low methodological quality).ConclusionsThis scoping review highlights the heterogeneity and gaps in methodological quality of the literature regarding the accuracy of MRI in diagnosing knee OA. Our adaptation of AMSTAR 2 will help to ensure systematic reviews of diagnostic tests are assessed more effectively and reliably. There is a need for standardization in future studies and reviews to strengthen the evidence base for the use of MRI as a diagnostic tool for knee OA.

Dataset Information

Structural and functional brain changes in people with knee osteoarthritis: a scoping review.

Background

Methodology

Results

Conclusion

Publications

Structural and functional brain changes in people with knee osteoarthritis: a scoping review.

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