Discussion
cognitive abnormalities, HAMD, neuropathic pain, anxiety, cognitive dysfunction, pain, depression
CORTEX, CEREBELLAR FUNCTION
Chronic persistent pain can lead to cognitive abnormalities in pain, subsequently causing anxiety or depression. Recent research shows that CEH patients suffer from the physical discomfort of pain, cognitive dysfunction, and psychological dysphoriaMoreover, an additional study has shown that CEH patients have synergistic increases or decreases in neuronal activity in localized brain tissue, suggesting that CEH involves pathological changes in multiple brain regions associated with regulating affective cognitionHerein, we found statistically significant changes in the function of frontal, middle gyrus, and middle temporal gyrus brain regions in CEH patients using the Mulligan maneuver. Furthermore, we identified correlations between these changes and clinical behavioral indicators. The middle frontal gyrus is a part of the frontal lobe that is thought to play a crucial role in regulating affective cognition, including memory and executive function. It is important to reduce pain sensitivity through affective cognitive modulationThe middle temporal gyrus is also a target of the Mulligan maneuver. Several studies have reported that the middle temporal gyrus is associated with emotional and sensory processing, including depression, anxiety, and pain ratings. Furthermore, it has been observed that enduring unpleasant emotional experiences resulting from pain can potentially create alterations in brain functionality. Herein, ReHo scores in the middle temporal gyrus were reduced and negatively correlated with VAS, HAMA, and HAMD, possibly due to the Mulligan maneuver’s protective inhibitory effect on the middle temporal gyrus. MEDINAAdditionally, we found that the manipulation had a benign moderating effect on changes in cerebellar function and a positive correlation between this change and VAS scores. Previous studies have focused on the cerebral cortex at the expense of cerebellar function. In a rat model of neuropathic pain, cerebellar activity was positively correlated with the development of neuropathic pain and prognosis