Shirui Cheng’s research while affiliated with Chengdu University of Traditional Chinese Medicine and other places

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Publications (37)


Abnormalities of Insular Functional Connectivity in Patients with Musculoskeletal Pain: A Meta-Analysis of Resting-State fMRI Studies
  • Literature Review

March 2025

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6 Reads

Brain Research Bulletin

Peng Lai

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Xingyao Chen

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Jiacheng Liu

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[...]

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Shirui Cheng

The flow diagram of the studies according to the PRISMA 2020 guidelines. n, number; PRISMA, preferred reporting items for systematic reviews and meta-analyses.
Resting-state functional difference between CLBP and HCs. Areas with increased resting-state functional activity value are displayed in yellow (A). L SFG, medial orbital; L ITG; R MFG; R Rolandic operculum; R precuneus; L MOG, and areas with decreased resting-state functional activity value are displayed in blue (B). Bilateral PoCG; R fusiform gyrus; R thalamus; R PreCG; R lingual gyrus; Bilateral cuneus cortex; L inferior parietal (excluding supramarginal and angular) gyri; L median cingulate / paracingulate gyri. L = left; R = right; SFG = superior frontal gyrus; ITG = inferior temporal gyrus; MFG = middle frontal gyrus; MOG = middle occipital gyrus; PoCG = postcentral gyrus; PreCG = precentral gyrus.
Demographic, clinical characteristics and technique details of the included studies.
Meta-analysis results of ReHo abnormalities in resting state fMRI between CLBP patients and HCs.
Meta-analysis results of ALFF abnormalities in resting state fMRI between CLBP patients and HCs.

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Multimodal abnormalities of brain function in chronic low back pain: a systematic review and meta-analysis of neuroimaging studies
  • Literature Review
  • Full-text available

February 2025

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19 Reads

Objectives Neuroimaging investigations into chronic low back pain (CLBP) have detected functional abnormalities across a spectrum of brain regions, yet the findings have often been inconsistent. In this meta-analysis, we integrated the existing data, delineating a pattern of coherent results from the encompassed studies. Methods A systematic search of neuroimaging studies investigating the brain activity differences between CLBP and Healthy controls (HCs) was conducted in seven databases up to December 22, 2024. An anisotropic effect-size signed differential mapping (AES-SDM)-based meta-analysis was carried out to report the results and perform a multimodal analysis. Results A total of 20 publications reporting on 24 experiments in this meta-analysis. The ReHo meta-analysis showed abnormal spontaneous activity of left inferior temporal gyrus (ITG), left superior frontal gyrus (SFG), right middle frontal gyrus (MFG), right precuneus, right fusiform gyrus and bilateral postcentral gyrus (PoCG) in CLBP patients. The ALFF meta-analysis demonstrated functional alterations in the right rolandic operculum (extending to the right insula and right IFG), left ITG, left middle occipital gyrus (MOG), left paracentral lobule, left PoCG and bilateral cuneus cortex in CLBP patients. The results of the functional group meta-analysis revealed that patients with CLBP displayed new decreased functional activity in the right thalamus, right precentral gyrus (PreCG) and right lingual gyrus. Conclusion Patients with CLBP exhibit extensive multimodal functional neuroimaging abnormalities, involving brain regions related to pain perception, emotional processing, cognitive functions, and both the visual and motor cortices. These meta-analysis findings might provide a valuable reference for the identification of potential therapeutic targets for CLBP in the brain.

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A Multimodal Meta-Analysis of Structural and Functional Alterations in the Brain of Knee Osteoarthritis Systematic Review

July 2024

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4 Reads

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1 Citation

Pain Physician

Background: Abnormalities of structural and functional brain regions might influence the persistence of knee pain, the progression, and the response to treatments in knee osteoarthritis (KOA). These complex alterations present a challenge to the understanding of its mechanism. Objectives: To meta-analyze the concurrence across structural and functional magnetic resonance imaging studies. Study design: Systematic review and meta-analysis. Setting: This meta-analysis examined all voxel-based morphometric (VBM) and amplitude of low-frequency fluctuation (ALFF) studies involving the whole-brain alterations of KOA. Methods: VBM and ALFF studies published up to May 7, 2023, were searched in the Web of Science, PubMed, EMBASE, Cochrane Library (CENTRAL), China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database, Chongqing VIP, Wanfang Database. Two independent researchers carried out study screening, quality assessment, clinical data extraction, and neuroimaging data extraction. The whole-brain voxel-based gray matter (GM) and brain activity data of KOA were collected from eligible studies and meta-analyzed using the anisotropic effect size-signed differential mapping (AES-SDM). Results: Fourteen studies were included in this study. In VBM meta-analyses, a total of 481 patients were enrolled in this study (252 KOA and 229 healthy patients). In the ALFF meta-analysis, a total of 518 patients were enrolled in this study (265 KOA and 253 healthy patients). According to the meta-analysis, KOA had increased GM volume in the right inferior frontal gyrus and decreased GM volume in the bilateral superior frontal gyrus, as well as increased brain activity in the left inferior frontal gyrus and inferior temporal gyrus, and decreased brain activity in the left middle occipital gyrus, right supramarginal gyrus, right superior frontal gyrus, and right superior parietal gyrus compared with healthy patients. Limitations: Most of the ALFF studies included in this meta-analysis were conducted in China. Our findings are exclusively addressed by the VBM and ALFF studies. The meta-regression between the duration of KOA, pain intensity and abnormal gray matter, and functional activity of brain regions in patients with KOA were unable to be analyzed. Conclusion: The results of this meta-analysis indicate that patients with KOA present significant abnormalities in GM volume and functional activity. These findings contribute to a better understanding of the structural and functional abnormalities seen in patients with KOA.



Study flowchart.
Locations of acupoints. Shenshu (BL23): On the back, 1.5 cun lateral to the lower border of the spinous process of the 2nd lumbar vertebra. Dachangshu (BL25): On the back, 1.5 cun lateral to the lower border of the spinous process of the 4th lumbar vertebra. Mingmen (GV4): In the lumbar region, on the posterior median line, in the depression below the spinous process of the 2nd lumbar vertebra. Yaoyangguan (GV3): On the lumbar region, on the posterior median line, in the depression below the spinous process of the 4th lumbar vertebra. Yaoyan (EX-B7): On the lower back, in the depression 3.5 cun lateral to the lower border of the spinous process of the 1st lumbar vertebra.
The Emotion Regulation of Acupuncture in Chronic Low Back Pain: A Clinical Neuroimaging Protocol

March 2024

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327 Reads

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1 Citation

Introduction Acupuncture is effective for patients with chronic low back pain (CLBP), which can relieve pain intensity and regulate negative emotional states such as pain-related anxiety and depression. Previous studies mainly discuss the analgesic mechanism of acupuncture treatment of CLBP, but there are multiple dimensions to pain, including sensation, emotion and cognition. Therefore, this study aims to investigate the central mechanism of acupuncture for CLBP from the perspective of emotional regulation by functional magnetic resonance imaging (fMRI). Methods and Analysis A total of 72 patients with CLBP will be recruited in the study and randomly assigned to the verum acupuncture group or the sham acupuncture group. The trail will last for 18 weeks including a 2-week baseline, a 4-week treatment and a 12-week for follow-up period. The primary outcomes are the visual analog scale (VAS) and the Japanese Orthopaedic Association Scores (JOA) score. The secondary outcomes are the 12-item short form health survey (SF-12), the state trait anxiety inventory (STAI), the self-rating anxiety scale (SAS) and self-rating depression scale (SDS). The VAS, JOA, STAI SAS and SDS will be collected at baseline, week 2, week 4, and after follow-up. The SF-12 will be evaluated at baseline, week 2 and week 4. Functional magnetic resonance imaging (MRI) data will be collected at baseline and the end of treatment. Emotion-related brain regions will be chosen as regions of interest (ROIs). The gray matter volume (GMV), amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), functional connectivity (FC), and large-scale functional brain network based on these ROIs will be analyzed within and between the two groups. Discussion This study will verify the emotional regulation of acupuncture and explore the mechanism of acupuncture for emotion regulation in patients with CLBP. Trial Registration Number https://www.chictr.org.cn/showproj.html?proj=195486, identifier: ChiCTR2300070557.


Flow diagram of this review.
The main brain regions of acupuncture for KOA based on neuroimaging studies.
Acupuncture-Related Therapy for Knee Osteoarthritis: A Narrative Review of Neuroimaging Studies

February 2024

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52 Reads

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6 Citations

Acupuncture has been widely applied for treating knee osteoarthritis (KOA). Numerous studies have found that acupuncture can effectively alleviate KOA symptoms. With the advancement of neuroimaging techniques, integrating neuroimaging with in-depth investigations of acupuncture mechanisms has emerged as a hot topic in traditional Chinese medical neuroscience research. This review aimed to analyze the study design and main findings from neuroimaging studies of acupuncture-related therapy for KOA to provide a reference for future research. Original studies were sourced from English databases (PubMed, Embase, and Cochrane Library) and Chinese databases (Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, the Chongqing VIP database, and Wanfang database). As a result, thirteen articles were ultimately included in this review. Functional magnetic resonance imaging was the most frequently used neuroimaging technique to explore cerebral responses to acupuncture-related therapy for KOA. Findings suggested that acupuncture-related therapy could regulate some brain regions in patients with KOA. Specifically, for acupuncture, it showed that the medial pain pathway and the limbic system were involved in the regulation of KOA. Meanwhile, moxibustion induced a wide range of functional activity throughout the entire brain.


The PLS-DA plot of serum metabolomics in PCOS patients (blue triangles) and healthy controls (red circles). ESI(−), R2Y = 0.627, Q2 = 0.421 (A); ESI(+), R2Y = 0.761, Q2 = 0.580 (B). PCOS, n = 20, Healthy controls, n = 20.
The dysbiosis of gut microbiota in the PCOS group. The ASVs Venn diagram of the PCOS and control (A); the rank abundance curve (B); alpha diversity, Chao1 index and Shannon index (C); PCoA analysis based on Bray–Curtis distance (D); NMDS analysis based on Bray–Curtis distance (stress = 0.169) (E).
Gut microbiota composition differences between PCOS and HC. The relative abundance of the gut microbiome at phylum level (Top 10) (A); and at genus level (B); Lefse analysis taxonomy branch diagram (C); Lefse analysis LDA histogram provided key features of each group (LDA > 3.5) (D).
Heat map of Pearson correlation analysis between gut microbiota and serum metabolites in PCOS patients.
Gut microbiome in PCOS associates to serum metabolomics: a cross-sectional study

November 2023

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63 Reads

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37 Citations

The association between gut microbiome and chronic metabolic disease including polycystic ovary syndrome (PCOS), is well documented, however, the relationship between the gut microbiota and serum metabolites remains unknown. In this study, untargeted metabolomics together with a 16S rRNA gene sequencing tool was used to detect small molecule serum metabolites and the gut microbiome. We identified 15 differential metabolites between PCOS patients and the healthy control. Lysophosphatidylcholine (LPC) (18:2, 20:3, 18:1, P-16:0, 17:0, 15:0, 18:3, 20:4), phosphatidylcholine(PC), ganglioside GA2 (d18:1/16:0) and 1-linoleoylglycerophosphocholine were increased in the PCOS group, and the concentrations of phosphoniodidous acid, bilirubin, nicotinate beta-d-ribonucleotide and citric acid were decreased in the PCOS group, suggesting a lipid metabolism and energy metabolism disorder in the PCOS patients. The diversity of gut microbiota in PCOS group was lower than that in healthy controls. Escherichia/Shigella, Alistipes and an unnamed strain 0319_6G20 belonging to Proteobacteria were important distinguishing genera (LDA > 3.5) in PCOS. Prevotella_9 was positively correlated with phosphoniodidous acid, nicotinate beta-d-ribonucleotide and citric acid concentrations, and negatively correlated with the concentration of LPC (20:3) and 1-linoleoylglycerophosphocholine; Roseburia was negatively correlated with LPC concentration (20:4), while the characteristic genus 0319_6G20 of PCOS was positively correlated with LPC concentration (20:3) (COR > 0.45). SF-36 in the PCOS group was significantly lower than that in the healthy control (HC) group, which was associated with the presence of Escherichia-Shigella and Alistipes. Our finding demonstrated the correlation between the gut microbiota and serum metabolites in PCOS, and therefore characteristic gut microbiota and metabolites may play an important role in the insulin resistance and the mood changes of PCOS patients.




The flow diagram for VBM studies included in the present meta-analysis.
Differences in gray matter between fibromyalgia patients and healthy subjects. L, left; R, right; X, x-axis MNI coordinates of this section of the brain region.
A systematic review and meta-analysis of voxel-based morphometric studies of fibromyalgia

May 2023

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68 Reads

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9 Citations

Objective Although neuroimaging investigations have revealed significant changes in brain structure in fibromyalgia (FM) patients, these findings are inconsistent. The current study conducted a systematic review and meta-analysis of voxel-based morphometric studies in order to comprehend those alterations in brain structure in FM patients. Methods Voxel-based morphometric (VBM) studies published up to January 17, 2023 were searched in the Web of Science, PubMed, EMBASE, Cochrane Library (CENTRAL), China National Knowledge Infrastructure (CNKI), Chongqing VIP, Wanfang Database. Two independent researchers carried out study screening, quality assessment, clinical data and neuroimaging data extraction. The whole-brain voxel-based gray matter (GM) data of FM patients were collected from eligible studies, and meta-analyzed using anisotropic effect size-signed differential mapping (AES-SDM). Results Twelve researches were included in this study, including 289 FM patients (mean age: 47.36 years) and 272 HS (mean age: 47.34 years). According to the meta-analysis, FM patients had increased GM in the right postcentral gyrus and left angular gyrus, and decreased GM in the right cingulate gyrus, right paracingulate gyrus, left cerebellum, and left gyrus rectus. Conclusion Our study suggests that fibromyalgia patients have altered gray matter in several brain regions that are involved in affective, cognitive functions, and in motor adaptations to pain processing.


Citations (30)


... Recent evidence has refuted the "pain matrix" hypothesis by challenging the notion that there is no uniform set of brain regions that can be equated with the presence of pain, particularly for different clinical chronic pain conditions that show unique patterns of brain activity (Apkarian et al., 2011). This meta-analysis reveals distinct brain activity patterns in PHN, differentiating it from other chronic pain disorders such as cervical spondylosis (Zhang and Ding, 2024) and knee osteoarthritis (Cheng et al., 2024). ...

Reference:

A meta-analysis of resting-state fMRI in postherpetic neuralgia using AES-SDM
A Multimodal Meta-Analysis of Structural and Functional Alterations in the Brain of Knee Osteoarthritis Systematic Review
  • Citing Article
  • July 2024

Pain Physician

... On the one hand, TC exercises reduce the generation of Lipopolysaccharide (LPS) through the gut microbiota, exerting a regulatory effect on inflammation [102]; on the other hand, TC can increase the production of Short-Chain Fatty Acid (SCFA) via the gut mucrobiota, reducing inflammatory factors [103], thus alleviating the inflammatory response in KOA from two perspectives. Additionally, KOA is often associated with irregularities in both structural and functional connectivity across different brain regions [104,105], particularly those related to pain perception. Consistent TC practice has the potential to prompt localized alterations in the precentral gyrus, insular sulcus, and middle frontal sulcus [106]. ...

Altered static and dynamic functional brain network in knee osteoarthritis: A resting-state functional magnetic resonance imaging study
  • Citing Article
  • April 2024

NeuroImage

... Approximately 80% of individuals will experience varying degrees of lower back pain at some point in their lives, and this condition is often associated with persistent pain that significantly impacts the patient's quality of life (3). The pain not only limits daily activities but may also lead to mental health problems such as depression and anxiety, creating a vicious cycle (4,5). Therefore, exploring effective treatment options is particularly important, especially for chronic lower back pain patients with recurrent symptoms. ...

The Emotion Regulation of Acupuncture in Chronic Low Back Pain: A Clinical Neuroimaging Protocol

... Pain Ther non-pharmacological treatment, acupuncture has been employed in China for more than 3000 years, and its efficacy in treating KOA has been widely recognized [5,34]. Nevertheless, there has always been an international aspiration for randomized controlled trial (RCT) studies to furnish evidence-based medical evidence. ...

Acupuncture-Related Therapy for Knee Osteoarthritis: A Narrative Review of Neuroimaging Studies

... Recent studies suggest a strong connection between this condition and the gut microbiome, highlighting specific bacteria associated with the metabolism of branchedchain amino acids (BCAAs) in those who are insulinresistant. Serum BCAA levels have been linked to the composition of gut microbiota, especially the presence of Prevotella copri and Bacteroides vulgatus, which are thought to promote insulin resistance [4] [19]. In addition, insulin resistance may result in hyperinsulinemia, which promotes the ovaries to produce androgens in excess, worsening PCOS symptoms [14]. ...

Gut microbiome in PCOS associates to serum metabolomics: a cross-sectional study

... Metabolomics excavates biologically meaningful information from complex data structures through the collection, pre-processing and data analysis of biological samples, providing biological explanations and solving clinical problems (18,19). The development and transformation application of metabolomics technology provides a new platform for constructing diagnostic and treatment strategies for PCOS, in addition to exploring its pathogenesis (20,21). The results of this study showed that, following COC treatment, there were significant changes in the serum metabolic components of patients with PCOS. ...

Gut microbiome in PCOS associates to serum metabolomics: a cross-sectional study

... By reducing pain-related ion channel activation and suppressing the release of inflammatory cytokines and chemokines, acupuncture can inhibit neuronal activity caused by neuropathic pain. Moreover, it might raise brain or spinal neurotransmitter levels, including opioid peptides, norepinephrine (NE), and 5hydroxytryptamine (5HT), to trigger the descending pain control system [16] . Eating fruits and vegetables lowers the level of Creactive protein (CRP) because they are high in vitamins, minerals, and antioxidants. ...

Editorial: Acupuncture for pain management

... We did not find any standardized quality assessment tools composed for morphometry studies. We used MINORS [9] and, in addition, a checklist proposed by Xin et al. specifically for neuroimaging reviews [10]. The second scale was primarly implemented in a morphometric study of patients with fibromyalgia, and we chose it after careful literature search, based on its comprehensivity. ...

A systematic review and meta-analysis of voxel-based morphometric studies of fibromyalgia

... 18,19 Acupuncture also demonstrates analgesic effects comparable to NSAIDs. 20 However, direct comparative evidence between shallow acupuncture and analgesic medications (eg, celecoxib) remains lacking, representing an innovative aspect of our current study. Besides, current research on shallow acupuncture for chronic neuropathic pain lacks the use of fMRI and DTI to investigate underlying brain mechanisms. ...

Modulation effects of different treatments on periaqueductal gray resting state functional connectivity in knee osteoarthritis knee pain patients

... Thus, she was admitted to our department. SMA has no side effects, strong safety, and remarkable curative effect that has been used to remedy numerous ailments [14]. As we have seen, in comparison with medicines, people are more likely to undergo SMA [15]. ...

Efficacy prediction of acupuncture treatment for migraine without aura based on multimodal MRI: A study protocol