Musculoskeletal science & practice · 2026
Alterations of insula structure and function in people with anterior shoulder pain: A cross-sectional study.
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Li Yujia, Liu Chengxiang, Diao Zhijun, Liu Yintao, Lu Jingdong, Li Huan, Zheng Yunsong, Wei Zi, Qiao Haifa, Liu Peng
Аннотация
BACKGROUND: The insula is involved in the pathophysiology of chronic pain. However, the possible role of the insula in people with anterior shoulder pain (ASP) remains unclear.
OBJECTIVES: To assess insula-related structural and functional abnormalities in people with ASP compared to healthy controls (HCs).
DESIGN: Cross-sectional study.
METHODS: Structural and functional magnetic resonance imaging data were acquired from 27 people with ASP and 20 HCs. Voxel-based morphometry method was used to detect changed gray matter volume (GMV) in the insula between the two groups. The changed insular regions were selected as seeds to further evaluate the structural and functional abnormalities in the two groups using sample entropy, structural covariance and functional connectivity (FC) methods. Receiver operating characteristic (ROC) curves were used to evaluate potential biomarkers for ASP. Correlations between neuroimaging findings and clinical characteristics were then assessed in people with ASP.
RESULTS: Compared to HCs, people with ASP showed increased GMV in the bilateral anterior insula (AI). The AI-based sample entropy analysis showed significant differences between the two groups. Altered AI-based patterns of structural covariance and FC between the two groups were connected to certain regions within the salience network, default mode network and sensorimotor network. ROC analysis exhibited better classification accuracies in FC of the right AI with the left posterior insula and right superior temporal gyrus.
CONCLUSIONS: The current findings suggest that aberrant insula-related structure and function may be associated with abnormal sensory information processing, dysfunction of relevant brain networks and disturbed motor control in people with ASP.
OBJECTIVES: To assess insula-related structural and functional abnormalities in people with ASP compared to healthy controls (HCs).
DESIGN: Cross-sectional study.
METHODS: Structural and functional magnetic resonance imaging data were acquired from 27 people with ASP and 20 HCs. Voxel-based morphometry method was used to detect changed gray matter volume (GMV) in the insula between the two groups. The changed insular regions were selected as seeds to further evaluate the structural and functional abnormalities in the two groups using sample entropy, structural covariance and functional connectivity (FC) methods. Receiver operating characteristic (ROC) curves were used to evaluate potential biomarkers for ASP. Correlations between neuroimaging findings and clinical characteristics were then assessed in people with ASP.
RESULTS: Compared to HCs, people with ASP showed increased GMV in the bilateral anterior insula (AI). The AI-based sample entropy analysis showed significant differences between the two groups. Altered AI-based patterns of structural covariance and FC between the two groups were connected to certain regions within the salience network, default mode network and sensorimotor network. ROC analysis exhibited better classification accuracies in FC of the right AI with the left posterior insula and right superior temporal gyrus.
CONCLUSIONS: The current findings suggest that aberrant insula-related structure and function may be associated with abnormal sensory information processing, dysfunction of relevant brain networks and disturbed motor control in people with ASP.