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Tamargo JA, Johnson AJ, Cruz-Almeida Y, Sibille KT. Measurement of Pain Frequency Associated with Knee Osteoarthritis: Future Directions. THE JOURNAL OF PAIN 2024:104545. [PMID: 38697495 DOI: 10.1016/j.jpain.2024.104545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 05/05/2024]
Affiliation(s)
- Javier A Tamargo
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Alisa J Johnson
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - Kimberly T Sibille
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
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Domenico LH, Tanner JJ, Mickle AM, Terry EL, Garvan C, Lai S, Deshpande H, Staud R, Redden D, Price CC, Goodin BR, Fillingim RB, Sibille KT. Environmental and sociocultural factors are associated with pain-related brain structure among diverse individuals with chronic musculoskeletal pain: intersectional considerations. Sci Rep 2024; 14:7796. [PMID: 38565879 PMCID: PMC10987661 DOI: 10.1038/s41598-024-58120-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
Chronic musculoskeletal pain including knee osteoarthritis (OA) is a leading cause of disability worldwide. Previous research indicates ethnic-race groups differ in the pain and functional limitations experienced with knee OA. However, when socioenvironmental factors are included in analyses, group differences in pain and function wane. Pain-related brain structures are another area where ethnic-race group differences have been observed. Environmental and sociocultural factors e.g., income, education, experiences of discrimination, and social support influence brain structures. We investigate if environmental and sociocultural factors reduce previously observed ethnic-race group differences in pain-related brain structures. Data were analyzed from 147 self-identified non-Hispanic black (NHB) and non-Hispanic white (NHW), middle and older aged adults with knee pain in the past month. Information collected included health and pain history, environmental and sociocultural resources, and brain imaging. The NHB adults were younger and reported lower income and education compared to their NHW peers. In hierarchical multiple regression models, sociocultural and environmental factors explained 6-37% of the variance in pain-related brain regions. Self-identified ethnicity-race provided an additional 4-13% of explanatory value in the amygdala, hippocampus, insula, bilateral primary somatosensory cortex, and thalamus. In the rostral/caudal anterior cingulate and dorsolateral prefrontal cortex, self-identified ethnicity-race was not a predictor after accounting for environmental, sociocultural, and demographic factors. Findings help to disentangle and identify some of the factors contributing to ethnic-race group disparities in pain-related brain structures. Numerous arrays of environmental and sociocultural factors remain to be investigated. Further, the differing sociodemographic representation of our NHB and NHW participants highlights the role for intersectional considerations in future research.
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Affiliation(s)
- Lisa H Domenico
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, 1225 Center Drive, Gainesville, FL, 32610, USA.
| | - Jared J Tanner
- Department of Clinical and Health Psychology, University of Florida, 1225 Center Drive, Gainesville, FL, 32603, USA
| | - Angela M Mickle
- Pain Research and Intervention Center of Excellence, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA
- Department of Physical Medicine and Rehabilitation, University of Florida, 3450 Hull Road, Gainesville, FL, 32607, USA
| | - Ellen L Terry
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, 1225 Center Drive, Gainesville, FL, 32610, USA
- Pain Research and Intervention Center of Excellence, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Cynthia Garvan
- Department of Anesthesiology, Division of Pain Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL, 32610, USA
| | - Song Lai
- Department of Radiation Oncology, University of Florida, 2000 SW Archer Road, Gainesville, FL, 32610, USA
| | - Hrishikesh Deshpande
- Department of Radiology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL, 35294, USA
| | - Roland Staud
- Department of Rheumatology, College of Medicine, University of Florida, 1600 SW Archer Rd, Gainesville, FL, 32610, USA
| | - David Redden
- Department of Biostatistics, University of Alabama at Birmingham, 1665 University Blvd #327, Birmingham, AL, 35294, USA
| | - Catherine C Price
- Department of Clinical and Health Psychology, University of Florida, 1225 Center Drive, Gainesville, FL, 32603, USA
| | - Burel R Goodin
- Department of Psychology, University of Alabama at Birmingham, Campbell Hall 415, 1300 University Blvd, Birmingham, AL, 35223, USA
- Department of Anesthesiology, Washington University, 660 S Euclid Ave, St. Louis, MO, 63110, USA
| | - Roger B Fillingim
- Pain Research and Intervention Center of Excellence, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA
- Department of Community Dentistry and Behavioral Science, University of Florida College of Dentistry, 1329 SW 16th Street, Gainesville, FL, 32610-3628, USA
| | - Kimberly T Sibille
- Department of Physical Medicine and Rehabilitation, University of Florida, 3450 Hull Road, Gainesville, FL, 32607, USA
- Department of Anesthesiology, Division of Pain Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL, 32610, USA
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McBenedict B, Petrus D, Pires MP, Pogodina A, Arrey Agbor DB, Ahmed YA, Castro Ceron JI, Balaji A, Abrahão A, Lima Pessôa B. The Role of the Insula in Chronic Pain and Associated Structural Changes: An Integrative Review. Cureus 2024; 16:e58511. [PMID: 38770492 PMCID: PMC11103916 DOI: 10.7759/cureus.58511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Chronic pain affects a substantial portion of the global population, significantly impacting quality of life and well-being. This condition involves complex mechanisms, including dysfunction of the autonomic nervous system, which plays a crucial role in pain perception. The insula, a key brain region involved in pain processing, plays a critical role in pain perception and modulation. Lesions in the insula can result in pain asymbolia, where pain perception remains intact but emotional responses are inappropriate. The insula is anatomically and functionally divided into anterior and posterior regions, with the posterior insula processing nociceptive input based on intensity and location before relaying it to the anterior insula for emotional mediation. Understanding the insula's intricate role in pain processing is crucial, as it is involved in encoding prediction errors and mediating emotional dimensions of pain perception. The focus of this review was on synthesizing existing literature on the role of the insula in chronic pain and associated structural changes. The goal was to integrate findings from various sources to provide a comprehensive overview of the topic. The search strategy included a combination of Medical Subject Headings (MeSH) and relevant keywords related to insula and chronic pain. The following databases were surveyed: PubMed, Embase, Scopus, and Web of Science. We identified a total of 2515 articles, and after following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline based on eligibility criteria, 46 articles were used to synthesize this review. Our study highlights the pivotal role of the insula in chronic pain processing and associated structural changes, integrating findings from diverse studies and neuroimaging investigations. Beyond mere pain sensation, the insula contributes to emotional awareness, attention, and salience detection within the pain network. Various chronic pain conditions reveal alterations in insular activity and connectivity, accompanied by changes in gray matter volume and neurochemical profiles. Interventions targeting the insula show promise in alleviating chronic pain symptoms. However, further research is needed to understand underlying mechanisms, which can aid in developing more effective therapeutic interventions for pain.
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Affiliation(s)
| | - Dulci Petrus
- Family Health, Directorate of Special Programs, Ministry of Health and Social Services, Windhoek, NAM
| | | | - Anna Pogodina
- Medicine and Surgery, University of Buckingham, Buckingham, GBR
| | | | - Yusuf A Ahmed
- Faculty of Medicine, Mansoura University, Mansoura, EGY
| | - Jose Ittay Castro Ceron
- Academic Medicine, Institute of Health Sciences, Autonomous University of the State of Hidalgo, Pachuca, MEX
| | - Aishwariya Balaji
- General Practice, Government Kilpauk Medical College and Hospital, Chennai, IND
| | - Ana Abrahão
- Public Health, Fluminense Federal University, Niterói, BRA
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Mickle AM, Sibille KT. Deciphering relationships between stress biomarkers and fibromyalgia syndrome with implications relevant to other chronic pain conditions. Pain 2024; 165:243-245. [PMID: 38100365 PMCID: PMC10752222 DOI: 10.1097/j.pain.0000000000003111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Affiliation(s)
- Angela M Mickle
- Department of Physical Medicine & Rehabilitation, University of Florida, Gainesville, FL, United States
| | - Kimberly T Sibille
- Department of Physical Medicine & Rehabilitation, University of Florida, Gainesville, FL, United States
- Division of Pain Medicine, Department of Anesthesiology, University of Florida, Gainesville, FL, United States
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Booker SQ, Merriwether EN, Powell-Roach K, Jackson S. From stepping stones to scaling mountains: overcoming racialized disparities in pain management. Pain Manag 2024; 14:5-12. [PMID: 38193345 PMCID: PMC10825727 DOI: 10.2217/pmt-2023-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/21/2023] [Indexed: 01/10/2024] Open
Affiliation(s)
- Staja Q Booker
- Department of Biobehavioral Nursing Science, University of Florida, College of Nursing, PO Box 100197, Gainesville, FL 32610, USA
| | - Ericka N Merriwether
- Department of Physical Therapy, New York University, NYU Steinhardt School of Culture, Education, & Human Development, NY 10010, USA
- Department of Medicine, NYU Grossman School of Medicine, NY 10010, USA
| | - Keesha Powell-Roach
- Department of Community & Population Health, University of Tennessee, Health Science Center, College of Nursing, College of Medicine, Genetics, Genomics & Informatics, Memphis, TN 38103, USA
| | - Simone Jackson
- Department of Biobehavioral Nursing Science, University of Florida, College of Nursing, PO Box 100197, Gainesville, FL 32610, USA
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Mickle AM, Tanner JJ, Olowofela B, Wu S, Garvan C, Lai S, Addison A, Przkora R, Edberg JC, Staud R, Redden D, Goodin BR, Price CC, Fillingim RB, Sibille KT. Elucidating individual differences in chronic pain and whole person health with allostatic load biomarkers. Brain Behav Immun Health 2023; 33:100682. [PMID: 37701788 PMCID: PMC10493889 DOI: 10.1016/j.bbih.2023.100682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/12/2023] [Accepted: 08/26/2023] [Indexed: 09/14/2023] Open
Abstract
Chronic pain is a stressor that affects whole person functioning. Persistent and prolonged activation of the body's stress systems without adequate recovery can result in measurable physiological and neurobiological dysregulation recognized as allostatic load. We and others have shown chronic pain is associated with measures of allostatic load including clinical biomarker composites, telomere length, and brain structures. Less is known regarding how different measures of allostatic load align. The purpose of the study was to evaluate relationships among two measures of allostatic load: a clinical composite and pain-related brain structures, pain, function, and socioenvironmental measures. Participants were non-Hispanic black and non-Hispanic white community-dwelling adults between 45 and 85 years old with knee pain. Data were from a brain MRI, questionnaires specific to pain, physical and psychosocial function, and a blood draw. Individuals with all measures for the clinical composite were included in the analysis (n = 175). Indicating higher allostatic load, higher levels of the clinical composite were associated with thinner insula cortices with trends for thinner inferior temporal lobes and dorsolateral prefrontal cortices (DLPFC). Higher allostatic load as measured by the clinical composite was associated with greater knee osteoarthritis pathology, pain disability, and lower physical function. Lower allostatic load as indicated by thicker insula cortices was associated with higher income and education, and greater physical functioning. Thicker insula and DLPFC were associated with a lower chronic pain stage. Multiple linear regression models with pain and socioenvironmental measures as the predictors were significant for the clinical composite, insular, and inferior temporal lobes. We replicate our previously reported bilateral temporal lobe group difference pattern and show that individuals with high chronic pain stage and greater socioenvironmental risk have a higher allostatic load as measured by the clinical composite compared to those individuals with high chronic pain stage and greater socioenvironmental buffers. Although brain structure differences are shown in individuals with chronic pain, brain MRIs are not yet clinically applicable. Our findings suggest that a clinical composite measure of allostatic load may help identify individuals with chronic pain who have biological vulnerabilities which increase the risk for poor health outcomes.
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Affiliation(s)
- Angela M. Mickle
- Department of Physical Medicine & Rehabilitation, University of Florida, 101 Newell Dr, Gainesville, FL 32603, USA
| | - Jared J. Tanner
- Department of Clinical and Health Psychology, University of Florida, 1225 Center Dr, Gainesville, FL 32603, USA
| | - Bankole Olowofela
- Department of Anesthesiology, Division of Pain Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL. 32610, USA
| | - Stanley Wu
- Department of Physical Medicine & Rehabilitation, University of Florida, 101 Newell Dr, Gainesville, FL 32603, USA
| | - Cynthia Garvan
- Department of Anesthesiology, Division of Pain Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL. 32610, USA
| | - Song Lai
- Department of Radiation Oncology & CTSI Human Imaging Core, University of Florida, 2004 Mowry Rd Gainesville, FL 32610, USA
| | - Adriana Addison
- Department of Psychology, University of Alabama at Birmingham, Campbell Hall 415, 1300 University Blvd, Birmingham, AL, 35223, USA
| | - Rene Przkora
- Department of Anesthesiology, Division of Pain Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL. 32610, USA
| | - Jeffrey C. Edberg
- Department of Medicine, Division of Clinical Immunology & Rheumatology, University of Alabama at Birmingham, 1825 University Blvd, Birmingham, AL 35294, USA
| | - Roland Staud
- Department of Medicine, University of Florida, PO Box 100277, Gainesville, FL, USA
| | - David Redden
- Department of Biostatistics, The University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL, USA
| | - Burel R. Goodin
- Department of Psychology, University of Alabama at Birmingham, Campbell Hall 415, 1300 University Blvd, Birmingham, AL, 35223, USA
- Department of Anesthesiology, Washington University, 660 S. Euclid Avenue, St. Louis, MO 63110, USA
| | - Catherine C. Price
- Department of Clinical and Health Psychology, University of Florida, 1225 Center Dr, Gainesville, FL 32603, USA
| | - Roger B. Fillingim
- Department of Community of Dentistry, University of Florida, 1329 SW 16th St, Room 5180, Gainesville, FL 32610, USA
| | - Kimberly T. Sibille
- Department of Physical Medicine & Rehabilitation, University of Florida, 101 Newell Dr, Gainesville, FL 32603, USA
- Department of Anesthesiology, Division of Pain Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL. 32610, USA
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Domenico L, Tanner J, Mickle A, Terry E, Garvan C, Lai S, Deshpande H, Staud R, Redden D, Price C, Goodin B, Fillingim R, Sibille K. Environmental and sociocultural factors are associated with pain-related brain structure among diverse individuals with chronic musculoskeletal pain. RESEARCH SQUARE 2023:rs.3.rs-3425338. [PMID: 37886554 PMCID: PMC10602144 DOI: 10.21203/rs.3.rs-3425338/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Chronic musculoskeletal pain is a leading cause of disability worldwide. Previous research indicates ethnic/race groups are disproportionately affected by chronic pain conditions. However, when considering socioenvironmental factors these disparities are no longer observed. Ethnic/race group differences have also been reported in pain-related brain structure. Given that environmental and sociocultural factors influence biology and health outcomes, this study aimed to investigate possible environmental and sociocultural contributions to structural differences in pain-related brain regions. A total of 147 non-Hispanic black and non-Hispanic white, middle and older aged adults with knee pain in the past month and a brain MRI are included in the analyses. Individuals also provided information specific to health and pain history and environmental and sociocultural resources. In hierarchical multiple regression models, sociocultural and environmental factors explained 6%-37% of the variance in thickness of pain-related brain regions, with seven of the eight brain regions being statistically significant. In the amygdala, hippocampus, insula, bilateral primary somatosensory cortex, and thalamus, ethnicity/race provided an additional 4%-13% of explanatory value. In the rostral/caudal anterior cingulate and dorsolateral prefrontal cortex, ethnicity/race was not a predictor after accounting for environmental, sociocultural, and other demographic measures. Findings inform health disparities research by elucidating the complexity of factors contributing to previously reported ethnicity/race group differences.
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Mickle AM, Domenico LH, Tanner JJ, Terry EL, Cardoso J, Glover TL, Booker S, Addison A, Gonzalez CE, Garvan CS, Redden D, Staud R, Goodin BR, Fillingim RB, Sibille KT. Elucidating factors contributing to disparities in pain-related experiences among adults with or at risk for knee osteoarthritis. FRONTIERS IN PAIN RESEARCH 2023; 4:1058476. [PMID: 36910251 PMCID: PMC9992984 DOI: 10.3389/fpain.2023.1058476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/25/2023] [Indexed: 02/24/2023] Open
Abstract
Background and purpose We and others have reported ethnic/race group differences in clinical pain, physical function, and experimental pain sensitivity. However, recent research indicates that with consideration for socioenvironmental factors, ethnicity/race differences become less or non-significant. Understanding of factors contributing to pain inequities are needed. Guided by the NIA and NIMHD Health Disparities Research Frameworks, we evaluate the contributions of environmental and behavioral factors on previously reported ethnic/race group differences in: (1) clinical pain, (2) physical function, and (3) experimental pain in individuals with knee pain. Methods Baseline data from Understanding of Pain and Limitations in Osteoarthritis Disease (UPLOAD) and UPLOAD-2 studies were analyzed. Participants were adults 45 to 85 years old who self-reported as non-Hispanic white (NHW) or black (NHB) with knee pain. A health assessment and quantitative sensory testing were completed. Sociodemographics, environmental, health, clinical and experimental pain, and physical functioning measures were included in nested regressions. Results Pooled data from 468 individuals, 57 ± 8 years of age, 63% women, and 53% NHB adults. As NHB adults were younger and reported greater socioenvironmental risk than the NHW adults, the term sociodemographic groups is used. With inclusion of recognized environmental and behavioral variables, sociodemographic groups remained a significant predictor accounting for <5% of the variance in clinical pain and physical function and <10% of variance in experimental pain. Conclusion The incorporation of environmental and behavioral factors reduced relationships between sociodemographic groups and pain-related outcomes. Pain sites, BMI, and income were significant predictors across multiple models. The current study adds to a body of research on the complex array of factors contributing to disparities in pain-related outcomes.
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Affiliation(s)
- Angela M. Mickle
- College of Medicine, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL, United States
- College of Dentistry, Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, United States
| | - Lisa H. Domenico
- College of Nursing, Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL, United States
| | - Jared J. Tanner
- College of Public Health and Health Professionals, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Ellen L. Terry
- College of Dentistry, Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, United States
- College of Nursing, Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL, United States
| | - Josue Cardoso
- College of Dentistry, Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, United States
| | - Toni L. Glover
- School of Nursing, Oakland University, Rochester, MI, United States
| | - Staja Booker
- College of Dentistry, Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, United States
- College of Nursing, Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL, United States
| | - Adriana Addison
- Department of Psychology, College of Arts and Science, University of Birmingham Alabama, Birmingham, AL, United States
| | - Cesar E. Gonzalez
- Department of Psychology, College of Arts and Science, University of Birmingham Alabama, Birmingham, AL, United States
| | - Cynthia S. Garvan
- College of Medicine, Department of Anesthesiology, University of Florida, Gainesville, FL, United States
| | - David Redden
- Department of Biostatistics, School of Public Health, University of Birmingham Alabama, Birmingham, AL, United States
| | - Roland Staud
- College of Medicine, Department of Rheumatology, University of Florida, Gainesville, FL, United States
| | - Burel R. Goodin
- Department of Psychology, College of Arts and Science, University of Birmingham Alabama, Birmingham, AL, United States
| | - Roger B. Fillingim
- College of Dentistry, Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, United States
| | - Kimberly T. Sibille
- College of Medicine, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL, United States
- College of Dentistry, Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, United States
- College of Medicine, Department of Anesthesiology, University of Florida, Gainesville, FL, United States
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Cody SL, Hobson JM, Gilstrap SR, Thomas SJ, Galinat D, Goodin BR. Sleep Disturbances and Chronic Pain in People with HIV: Implications for HIV-Associated Neurocognitive Disorders. CURRENT SLEEP MEDICINE REPORTS 2022; 8:124-131. [PMID: 36687512 PMCID: PMC9851157 DOI: 10.1007/s40675-022-00236-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2022] [Indexed: 11/14/2022]
Abstract
Purpose of Review Antiretroviral therapy has significantly reduced morbidity and mortality in people with HIV. Despite being virally suppressed, sleep disturbances, chronic pain, and neurocognitive impairments persist which can negatively impact quality of life for people with HIV. This article presents relevant literature related to sleep disturbances and chronic pain in people with HIV. The potential impact of these comorbidities on cognition is discussed with implications for managing HIV-associated neurocognitive disorder (HAND). Recent Findings People with HIV and chronic pain report greater insomnia and depressive symptoms compared to those without chronic pain. The neurotoxic effects of HIV itself and sleep and chronic pain induced inflammation can contribute to poorer cognitive outcomes. Summary Sleep disturbances and chronic pain are prevalent conditions in people with HIV that may perpetuate the development and exacerbation of HAND. Sleep and pain interventions may preserve cognitive function and improve quality of life for people aging with HIV.
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Affiliation(s)
- Shameka L Cody
- Capstone College of Nursing, The University of Alabama, Tuscaloosa, Alabama, U.S.A
| | - Joanna M Hobson
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A
| | - Shannon R Gilstrap
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A
| | - S Justin Thomas
- Department of Psychiatry & Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A
| | - David Galinat
- Alabama Water Institute, The University of Alabama, Tuscaloosa, Alabama, U.S.A
| | - Burel R Goodin
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A
- Center for Addiction & Pain Prevention & Intervention (CAPPI), University of Alabama at Birmingham, Birmingham, AL, U.S.A
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Liang HB, Dong L, Cui Y, Wu J, Tang W, Du X, Liu JR. Significant Structural Alterations and Functional Connectivity Alterations of Cerebellar Gray Matter in Patients With Somatic Symptom Disorder. Front Neurosci 2022; 16:816435. [PMID: 35350558 PMCID: PMC8957795 DOI: 10.3389/fnins.2022.816435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Recent studies have revealed a strong association between the cerebellum and psychiatric disorders. However, the structural changes in the cerebellar regions and functional connectivity (FC) patterns in patients with somatic symptom disorder (SSD) have not been elucidated. Methods Thirty-seven patients with SSD (29 drug-naive and 8 medicated patients) and 37 sex- and age-matched healthy controls (HCs) were recruited and underwent resting-state functional magnetic resonance imaging scans. The spatially unbiased infratentorial (SUIT) cerebellar atlas-based voxel-based morphometry was used to investigate the changes in cerebellar regional gray matter (GM). Seed-based FC was further computed to explore the pattern of abnormal FC across the whole brain. Correlations were calculated to investigate the relationship between cerebellar structural (and FC) changes and clinical characteristics. Results After controlling for age, sex, total intracranial volume, medication, and mean FD covariates, all patients with SSD had increased mean GM volume (GMV) in the posterior lobules of the cerebellum bilaterally when compared with HCs, specifically, in the bilateral cerebellar crura I and II. Patients with SSD showed significantly stronger FC between the right crura I and II and bilateral precuneus inferior parietal region, and postcentral gyrus, extending to the superior parietal lobe, cingulate gyrus, and the white matter subgyral. In addition to the two clusters, right lingual gyrus was also a surviving cluster with significantly higher FC. Partial correlation analysis revealed that the degree of regional GMV increases in the two significant clusters and the Hamilton Depression Scale (HAMD) score was negatively correlated. Moreover, the FC of right crura I and II with the left parietal lobe and right lingual gyrus were also negatively associated with the HAMD score. Conclusions SSD exhibited significant microstructural changes and changes in FC pattern in the posterior cerebellar lobe. These results shed new light on the psychological and neural substrates of SSD and may serve as a potential treatment target for SSD based on the cerebellar area.
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Affiliation(s)
- Huai-Bin Liang
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liao Dong
- Shanghai Key Laboratory of Magnetic Resonance, Department of Physics, School of Physics and Electronic Science, East China Normal University, Shanghai, China
| | - Yangyang Cui
- Shanghai Key Laboratory of Magnetic Resonance, Department of Physics, School of Physics and Electronic Science, East China Normal University, Shanghai, China
| | - Jing Wu
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Tang
- Shanghai Key Laboratory of Magnetic Resonance, Department of Physics, School of Physics and Electronic Science, East China Normal University, Shanghai, China
| | - Xiaoxia Du
- Shanghai Key Laboratory of Magnetic Resonance, Department of Physics, School of Physics and Electronic Science, East China Normal University, Shanghai, China
- School of Psychology, Shanghai University of Sport, Shanghai, China
- *Correspondence: Xiaoxia Du,
| | - Jian-Ren Liu
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Jian-Ren Liu,
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