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Jin P, Wang F, Zeng F, Yu J, Cui F, Yang B, Zhang L. Revealing the mechanism of central pain hypersensitivity in primary dysmenorrhea: evidence from neuroimaging. Quant Imaging Med Surg 2024; 14:3075-3085. [PMID: 38617141 PMCID: PMC11007516 DOI: 10.21037/qims-23-1687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/29/2024] [Indexed: 04/16/2024]
Abstract
Background Primary dysmenorrhea (PDM) is the most common problem in menstruating women. A number of functional magnetic resonance imaging (fMRI) study have revealed that the brain plays a crucial role in the pathophysiology of PDM. However, these results have been inconsistent, and there is a lack of a comprehensive fMRI study to clarify the onset and long-term effects of PDM. The aim of this study was thus to investigate the onset and long-term effects of PDM in a cohort of patients with PDM. Methods This study employed a cross-sectional design with prospective data collection, in which 25 patients with PDM and 20 healthy controls (HCs) were recruited. The patients with PDM underwent fMRI scans both during the PDM during the pain phase (PDM-P) and nonpain phase (PDM-NP). The long-term effects of PDM on the brain was assessed by comparing PDM-NP findings with those of HCs, and the central mechanism of PDM was assessed by comparing the PDM-P findings with those of PDM-NP. To identify changes in brain function, the amplitude of low-frequency fluctuations and the regional homogeneity (ReHo) were measured. To assess changes in brain structure, voxel-based morphometry (VBM) was applied. The periaqueductal gray (PAG) was set as a region of for conducting seed-based whole-brain functional connectivity (FC) analysis. Subsequently, Pearson correlation analyses were employed to evaluate the associations between the abnormal brain region and the clinical information of the patients. Results There were neither functional nor structural differences between patients in the PDM-NP and HCs. Compared with those in PDM-NP, those in PDM-P showed increased ReHo in the left dorsolateral prefrontal cortex (DLPFC) but decreased FC between PAG and right superior parietal gyrus, bilateral inferior parietal gyrus, right calcarine gyrus, left superior occipital gyrus, left precentral gyrus, right DLPFC, and left crus I of the cerebellar hemisphere. Conclusions The results from this study suggest that the mechanism of central pain hypersensitivity of PDM may be related to the disorder of the FC between the PAG and descending pain modulation system, default mode network (DMN), and occipital lobe. These findings could help us better understand the pathophysiology of PDM from a neuroimaging perspective.
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Affiliation(s)
- Ping Jin
- Department of Radiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Fangli Wang
- Department of Acupuncture and Moxibustion, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Fanfan Zeng
- Department of Ultrasound, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Jing Yu
- Department of Acupuncture and Moxibustion, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Feng Cui
- Department of Radiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Bingkui Yang
- Department of Radiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Luping Zhang
- Department of Radiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
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Rogers SK, Ahamadeen N, Chen CX, Mosher CE, Stewart JC, Rand KL. Dysmenorrhea and psychological distress: a meta-analysis. Arch Womens Ment Health 2023; 26:719-735. [PMID: 37632569 DOI: 10.1007/s00737-023-01365-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 08/14/2023] [Indexed: 08/28/2023]
Abstract
Dysmenorrhea is characterized by pelvic pain associated with menstruation. Similar to people with other pain conditions, females who experience dysmenorrhea report increased psychological distress. However, the pooled magnitude of this association has not been quantified across studies. Accordingly, this meta-analytic review quantifies the magnitude of the associations between dysmenorrhea severity and psychological distress. We conducted a systematic search of the literature using PsycINFO, PubMed, CINHAL, Embase, and Web of Science. Analyzed studies provided observational data on dysmenorrhea severity and anxiety symptoms, depressive symptoms, and/or global psychological distress. A total of 44 studies were included, and three random-effects meta-analyses were conducted, with average pooled effect sizes calculated using Person's r. We found significant, positive associations between measures of dysmenorrhea severity and measures of depressive symptoms (r = 0.216), anxiety symptoms (r = 0.207), and global psychological distress (r = 0.311). Our review suggests that females with greater dysmenorrhea severity experience greater psychological distress. Future directions include defining a clinically meaningful dysmenorrhea severity threshold, understanding the mechanisms and directionality underlying the dysmenorrhea-psychological distress relationship, and designing and testing interventions to jointly address dysmenorrhea and psychological distress.
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Affiliation(s)
- Sarah K Rogers
- School of Science, Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St., LD 113A, Indianapolis, IN, 46202, USA.
| | - Naheeda Ahamadeen
- School of Science, Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St., LD 113A, Indianapolis, IN, 46202, USA
| | - Chen X Chen
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | - Catherine E Mosher
- School of Science, Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St., LD 113A, Indianapolis, IN, 46202, USA
| | - Jesse C Stewart
- School of Science, Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St., LD 113A, Indianapolis, IN, 46202, USA
| | - Kevin L Rand
- School of Science, Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford St., LD 113A, Indianapolis, IN, 46202, USA
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Dong Y, Li MJ, Hong YZ, Li WJ. Insight into Dysmenorrhea Research from 1992 to 2022: A Bibliometric Analysis. J Pain Res 2023; 16:3591-3611. [PMID: 37915864 PMCID: PMC10617534 DOI: 10.2147/jpr.s430233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/29/2023] [Indexed: 11/03/2023] Open
Abstract
Dysmenorrhea, classified as primary dysmenorrhea and secondary dysmenorrhea, is a common gynecological symptom that seriously affects female daily life. At present, studies on dysmenorrhea are numerous and complex. To better reflect the trend and innovative progress of dysmenorrhea-related research, this study screened papers on the Web of Science from January 1, 1992, to December 31, 2022. A total of 1012 papers were selected and analyzed for their affiliated countries, institutions, authors, keywords, etc. China is the country with the most academic output, Beijing University of Traditional Chinese Medicine is the most influential institution, and Yang Jie, from Chengdu University of Traditional Chinese Medicine, China, is the scholar with the most papers. We consider that the current research focus is on pathogenesis, treatment, epidemiology, and self-management. With increasing research on functional connectivity between dysmenorrhea and various brain regions, functional connectivity has gradually become the forefront of research. We hope our study can promote the further study of dysmenorrhea.
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Affiliation(s)
- Yin Dong
- Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Ming-Jing Li
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Yan-Zhu Hong
- School of Medicine, Xiamen University, Xiamen, People’s Republic of China
| | - Wen-Jie Li
- Shanghai Innovation Center of TCM Health Service, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
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Luo D, Liu Y, Zhang N, Wang T. Differences in the distribution of triggers among resting state networks in patients with juvenile myoclonic epilepsy explained by network analysis. Front Neurosci 2023; 17:1214687. [PMID: 37859762 PMCID: PMC10582565 DOI: 10.3389/fnins.2023.1214687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 08/25/2023] [Indexed: 10/21/2023] Open
Abstract
Background Juvenile myoclonus epilepsy (JME) is an idiopathic generalized epilepsy syndrome. Functional connectivity studies based on graph theory have demonstrated changes in functional connectivity among different brain regions in patients with JME and healthy controls. However, previous studies have not been able to clarify why visual stimulation or increased cognitive load induces epilepsy symptoms in only some patients with JME. Methods This study constructed a small-world network for the visualization of functional connectivity of brain regions in patients with JME, based on system mapping. We used the node reduction method repeatedly to identify the core nodes of the resting brain network of patients with JME. Thereafter, a functional connectivity network of the core brain regions in patients with JME was established, and it was analyzed manually with white matter tracks restriction to explain the differences in symptom distribution in patients with JME. Results Patients with JME had 21 different functional connections in their resting state, and no significant differences in their distribution were noted. The thalamus, cerebellum, basal ganglia, supplementary motor area, visual cortex, and prefrontal lobe were the core brain regions that comprised the functional connectivity network in patients with JME during their resting state. The betweenness centrality of the prefrontal lobe and the visual cortex in the core functional connectivity network of patients with JME was lower than that of the other brain regions. Conclusion The functional connectivity and node importance of brain regions of patients with JME changed dynamically in the resting state. Abnormal discharges originating from the thalamus, cerebellum, basal ganglia, supplementary motor area, visual cortex, and prefrontal cortex are most likely to lead to seizures in patients with JME. Further, the low average value of betweenness centrality of the prefrontal and visual cortices explains why visual stimulation or increased cognitive load can induce epileptic symptoms in only some patients with JME.
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Affiliation(s)
- Dadong Luo
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
- Second School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Yaqing Liu
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
- Second School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Ningning Zhang
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
- Second School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Tiancheng Wang
- Department of Neurology, Lanzhou University Second Hospital, Lanzhou, China
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Liu R, He M, Sun M, Wang L, Cao J, Yu Q, Wang F, Li T. Application of fMRI techniques in the study of acupuncture for gynecological diseases: A review. Medicine (Baltimore) 2023; 102:e33268. [PMID: 36897670 PMCID: PMC9997817 DOI: 10.1097/md.0000000000033268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 02/23/2023] [Indexed: 03/11/2023] Open
Abstract
Acupuncture therapy, as a characteristic of Chinese medical therapy, has a long history and remarkable effect in the treatment of gynecological diseases, and so far, it has formed a complete treatment system, but its efficacy and mechanism of action remain unclear. Functional magnetic resonance imaging, a visual technique, provides an objective basis for the study of acupuncture in the treatment of gynecological diseases. This paper summarizes the current status of acupuncture in the treatment of gynecological diseases and summarizes the progress of functional magnetic resonance imaging research related to acupuncture in the treatment of gynecological diseases in the past 10 years, mainly including the common types of gynecological diseases in acupuncture clinics, and the commonly used acupuncture points. This study is expected to provide literature support for subsequent research on the central mechanisms of acupuncture in the treatment of gynecological diseases.
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Affiliation(s)
- Renming Liu
- Acupuncture and Moxibustion Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Min He
- Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Mengmeng Sun
- Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Lin Wang
- Acupuncture and Moxibustion Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Jiazhen Cao
- Acupuncture and Moxibustion Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Qianhui Yu
- Acupuncture and Moxibustion Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Fuchun Wang
- Acupuncture and Moxibustion Academy, Changchun University of Chinese Medicine, Changchun, China
| | - Tie Li
- Acupuncture and Moxibustion Academy, Changchun University of Chinese Medicine, Changchun, China
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Lee LC, Chen YY, Li WC, Yang CJ, Liu CH, Low I, Chao HT, Chen LF, Hsieh JC. Adaptive neuroplasticity in the default mode network contributing to absence of central sensitization in primary dysmenorrhea. Front Neurosci 2023; 17:1094988. [PMID: 36845415 PMCID: PMC9947468 DOI: 10.3389/fnins.2023.1094988] [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: 11/10/2022] [Accepted: 01/25/2023] [Indexed: 02/11/2023] Open
Abstract
Introduction Primary dysmenorrhea (PDM), the most prevalent gynecological problem among women of reproductive age, presents as a regular pattern of cyclic menstrual pain. The presence or absence of central sensitization (i.e., pain hypersensitivity) in cases of PDM is a contentious issue. Among Caucasians, the presence of dysmenorrhea is associated with pain hypersensitivity throughout the menstrual cycle, indicating pain amplification mediated by the central nervous system. We previously reported on the absence of central sensitization to thermal pain among Asian PDM females. In this study, functional magnetic resonance imaging was used to reveal mechanisms underlying pain processing with the aim of explaining the absence of central sensitization in this population. Methods Brain responses to noxious heat applied to the left inner forearm of 31 Asian PDM females and 32 controls during their menstrual and periovulatory phases were analyzed. Results and discussion Among PDM females experiencing acute menstrual pain, we observed a blunted evoked response and de-coupling of the default mode network from the noxious heat stimulus. The fact that a similar response was not observed in the non-painful periovulatory phase indicates an adaptive mechanism aimed at reducing the impact of menstrual pain on the brain with an inhibitory effect on central sensitization. Here we propose that adaptive pain responses in the default mode network may contribute to the absence of central sensitization among Asian PDM females. Variations in clinical manifestations among different PDM populations can be attributed to differences in central pain processing.
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Affiliation(s)
- Lin-Chien Lee
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Ya-Yun Chen
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Chi Li
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Biological Science and Technology, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Ching-Ju Yang
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ching-Hsiung Liu
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan,Institute of Traditional Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Department of Neurology, Lotung Poh-Ai Hospital, Yilan, Taiwan
| | - Intan Low
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiang-Tai Chao
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-Fen Chen
- Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan,Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jen-Chuen Hsieh
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan,Department of Biological Science and Technology, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan,Center for Intelligent Drug Systems and Smart Bio-Devices, National Yang Ming Chiao Tung University, Hsinchu, Taiwan,*Correspondence: Jen-Chuen Hsieh,
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Liu N, Li Y, Hong Y, Huo J, Chang T, Wang H, Huang Y, Li W, Zhang Y. Altered brain activities in mesocorticolimbic pathway in primary dysmenorrhea patients of long-term menstrual pain. Front Neurosci 2023; 17:1098573. [PMID: 36793538 PMCID: PMC9922713 DOI: 10.3389/fnins.2023.1098573] [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: 11/15/2022] [Accepted: 01/09/2023] [Indexed: 02/01/2023] Open
Abstract
Background Patients with primary dysmenorrhea (PDM) often present with abnormalities other than dysmenorrhea including co-occurrence with other chronic pain conditions and central sensitization. Changes in brain activity in PDM have been demonstrated; however, the results are not consistent. Herein, this study probed into altered intraregional and interregional brain activity in patients with PDM and expounded more findings. Methods A total of 33 patients with PDM and 36 healthy controls (HCs) were recruited and underwent a resting-state functional magnetic resonance imaging scan. Regional homogeneity (ReHo) and mean amplitude of low-frequency fluctuation (mALFF) analysis were applied to compare the difference in intraregional brain activity between the two groups, and the regions with ReHo and mALFF group differences were used as seeds for functional connectivity (FC) analysis to explore the difference of interregional activity. Pearson's correlation analysis was conducted between rs-fMRI data and clinical symptoms in patients with PDM. Results Compared with HCs, patients with PDM showed altered intraregional activity in a series of brain regions, including the hippocampus, the temporal pole superior temporal gyrus, the nucleus accumbens, the pregenual anterior cingulate cortex, the cerebellum_8, the middle temporal gyrus, the inferior temporal gyrus, the rolandic operculum, the postcentral gyrus and the middle frontal gyrus (MFG), and altered interregional FC mainly between regions of the mesocorticolimbic pathway and regions associated with sensation and movement. The anxiety symptoms are correlated with the intraregional activity of the right temporal pole superior temporal gyrus and FC between MFG and superior frontal gyrus. Conclusion Our study showed a more comprehensive method to explore changes in brain activity in PDM. We found that the mesocorticolimbic pathway might play a key role in the chronic transformation of pain in PDM. We, therefore, speculate that the modulation of the mesocorticolimbic pathway may be a potential novel therapeutic mechanism for PDM.
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Affiliation(s)
- Ni Liu
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Yingqiu Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yueying Hong
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Jianwei Huo
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Tai Chang
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Haoyuan Wang
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Yiran Huang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Wenxun Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China,Wenxun Li ✉
| | - Yanan Zhang
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China,*Correspondence: Yanan Zhang ✉
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Yi SJ, Chen RB, Zhong YL, Huang X. The Effect of Long-Term Menstrual Pain on Large-Scale Brain Network in Primary Dysmenorrhea Patients. J Pain Res 2022; 15:2123-2131. [PMID: 35923844 PMCID: PMC9342881 DOI: 10.2147/jpr.s366268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/01/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose Primary dysmenorrhea (PD) is a common gynecological disease, characterized by crampy and suprapubic pain occurring with menses. Growing evidences demonstrated that PD patients were associated with abnormalities in brain function and structure. However, little is known regarding whether the large-scale brain network changes in PD patients. The purpose of this study was to investigate the effect of long-term menstrual pain on large-scale brain network in PD patients using independent component analysis (ICA) method. Methods Twenty-eight PD patients (female, mean age, 24.25±1.00 years) and twenty-eight healthy controls (HCs) (mean age, 24.46±1.31 years), closely matched for age, sex, and education, underwent resting-state magnetic resonance imaging scans. ICA was applied to extract the resting-state networks (RSNs) in two groups. Then, two-sample t-tests were conducted to investigate different intranetwork FCs within RSNs and interactions among RSNs between two groups. Results Compared to the HC group, PD patients showed significant increased intra-network FCs within the auditory network (AN), sensorimotor network (SMN), right executive control network (RECN). However, PD patients showed significant decreased intra-network FCs within ventral default mode network (vDMN) and salience network (SN). Moreover, FNC analysis showed increased VN-AN and decreased VN-SMN functional connectivity between two groups. Conclusion Our study highlighted that PD patients had abnormal brain networks related to auditory, sensorimotor and higher cognitive network. Our results offer important insights into the altered large-scale brain network neural mechanisms of pain in PD patients.
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Affiliation(s)
- Si-Jie Yi
- Department of Gynecology and Obstetrics, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, People’s Republic of China
| | - Ri-Bo Chen
- Department of Radiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, People’s Republic of China
| | - Yu-Lin Zhong
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, People’s Republic of China
| | - Xin Huang
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, People’s Republic of China
- Correspondence: Xin Huang, Department of Ophthalmology, Jiangxi Provincial People’s Hospital, No. 152, Ai Guo Road, Dong Hu District, Nanchang, Jiangxi, 330006, People’s Republic of China, Tel +86 15879215294, Email
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Zheng CJ, Van Drunen S, Egorova-Brumley N. Neural correlates of co-occurring pain and depression: an activation-likelihood estimation (ALE) meta-analysis and systematic review. Transl Psychiatry 2022; 12:196. [PMID: 35545623 PMCID: PMC9095719 DOI: 10.1038/s41398-022-01949-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 11/09/2022] Open
Abstract
The relationship between pain and depression is thought to be bidirectional and the underlying neurobiology 'shared' between the two conditions. However, these claims are often based on qualitative comparisons of brain regions implicated in pain or depression, while focused quantitative studies of the neurobiology of pain-depression comorbidity are lacking. Particularly, the direction of comorbidity, i.e., pain with depression vs. depression with pain, is rarely addressed. In this systematic review (PROSPERO registration CRD42020219876), we aimed to delineate brain correlates associated with primary pain with concomitant depression, primary depression with concurrent pain, and equal pain and depression comorbidity, using activation likelihood estimation (ALE) meta-analysis. Neuroimaging studies published in English until the 28th of September 2021 were evaluated using PRISMA guidelines. A total of 70 studies were included, of which 26 reported stereotactic coordinates and were analysed with ALE. All studies were assessed for quality by two authors, using the National Institute of Health Quality Assessment Tool. Our results revealed paucity of studies that directly investigated the neurobiology of pain-depression comorbidity. The ALE analysis indicated that pain with concomitant depression was associated with the right amygdala, while depression with concomitant pain was related primarily to the left dorsolateral prefrontal cortex (DLPFC). We provide evidence that pain and depression have a cumulative negative effect on a specific set of brain regions, distinct for primary diagnosis of depression vs. pain.
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Affiliation(s)
| | | | - Natalia Egorova-Brumley
- The University of Melbourne, Parkville, VIC, Australia.
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia.
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Shen Y, Wang W, Wang Y, Yang L, Yuan C, Yang Y, Wu F, Wang J, Deng Y, Wang X, Liu H. Not Only in Sensorimotor Network: Local and Distant Cerebral Inherent Activity of Chronic Ankle Instability—A Resting-State fMRI Study. Front Neurosci 2022; 16:835538. [PMID: 35197822 PMCID: PMC8859266 DOI: 10.3389/fnins.2022.835538] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/10/2022] [Indexed: 12/26/2022] Open
Abstract
BackgroundIncreasing evidence has proved that chronic ankle instability (CAI) is highly related to the central nervous system (CNS). However, it is still unclear about the inherent cerebral activity among the CAI patients.PurposeTo investigate the differences of intrinsic functional cerebral activity between the CAI patients and healthy controls (HCs) and further explore its correlation with clinical measurement in CAI patients.Materials and MethodsA total of 25 CAI patients and 39 HCs were enrolled in this study. Resting-state functional magnetic resonance imaging (rs-fMRI) was used to detect spontaneous cerebral activity. The metrics of amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) of the two groups were compared by two-sample t-test. The brain regions that demonstrated altered functional metrics were selected as the regions of interest (ROIs). The functional connectivity (FC) was analyzed based on the ROIs. The Spearman correlation was calculated between rs-fMRI metrics and clinical scale scores.ResultsCompared with HCs, CAI patients showed higher ALFF and ReHo values in the right postcentral gyrus, the right precentral gyrus, and the right middle frontal gyrus, while lower fALFF values in the orbital-frontal cortex (OFC, p < 0.01 after correction). Increasing FC between the right precentral gyrus and the right postcentral gyrus while decreasing FC between the right precentral gyrus and the anterior cingulum cortex (ACC), the right middle frontal gyrus and the left middle temporal gyrus, and the OFC and left inferior parietal lobule (IPL) was observed. In addition, in the CAI group, the ReHo value negatively correlated with the Cumberland Ankle Instability Tool score in the right middle frontal gyrus (r = −0.52, p = 0.007).ConclusionThe CAI patients exhibited enhanced and more coherent regional inherent neuronal activity within the sensorimotor network while lower regional inherent activity in pain/emotion modulation related region. In addition, the information exchanges were stronger within the sensorimotor network while weaker between distant interhemispheric regions. Besides, the increased inherent activity in the right middle frontal gyrus was related to clinical severity. These findings may provide insights into the pathophysiological alteration in CNS among CAI patients.
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Affiliation(s)
- Yiyuan Shen
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Weiwei Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yin Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Radiology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Liqin Yang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
| | - Chengjie Yuan
- Department of Orthopedic, Huashan Hospital, Fudan University, Shanghai, China
| | - Yang Yang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Fei Wu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Junlong Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yan Deng
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xu Wang
- Department of Orthopedic, Huashan Hospital, Fudan University, Shanghai, China
- Xu Wang,
| | - Hanqiu Liu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Hanqiu Liu,
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11
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Peng SL, Yang HC, Lee YC, Chen CM, Chen YY, Tu CH. Analgesia Effect of Verum and Sham Acupuncture Treatments in Primary Dysmenorrhea: A MRI Pilot Study. J Pers Med 2021; 11:1244. [PMID: 34945716 PMCID: PMC8706482 DOI: 10.3390/jpm11121244] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/17/2022] Open
Abstract
Acupuncture is an alternative treatment for primary dysmenorrhea (PDM). However, mechanisms by which acupuncture exerts its analgesic properties are still unclear. This study aimed to explore the cerebral blood flow (CBF) response to verum and sham acupuncture treatments, and further investigate whether pre-treatment CBF is capable of assessing symptom changes after interventions. A total of 11 PDM patients in the verum group and 12 patients in the sham group participated in this study. Pain rating index (PRI), CBF, and gonadal hormone levels were acquired before and after 8-week treatments. Both verum and sham acupuncture treatments exert its analgesic effect on PDM after intervention as PRI reduced (p < 0.05). Blood gonadal levels were not significantly different after acupuncture in both groups (all p > 0.05). In the verum group, intervention-related decreases in CBF were observed in the right dorsal anterior cingulate cortex. In the sham group, regions identified as showing reductions in CBF after acupuncture included the left ventromedial prefrontal cortex, left caudate, and left insula. Patients with higher baseline CBF in the left precuneus and right hippocampus were accompanied with worse treatment response to acupuncture intervention. Mechanisms of verum and sham acupuncture treatments are dissimilar as manifested by different brain responses.
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Affiliation(s)
- Shin-Lei Peng
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 404332, Taiwan;
| | - Hui-Chieh Yang
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 404332, Taiwan;
| | - Yu-Chen Lee
- Department of Acupuncture, China Medical University Hospital, Taichung 404333, Taiwan;
| | - Chun-Ming Chen
- Department of Medical Imaging, China Medical University Hospital, Taichung 404333, Taiwan;
| | - Ying-Yu Chen
- Department of Chinese Medicine Gynecology, China Medical University Hospital, Taichung 404333, Taiwan;
| | - Cheng-Hao Tu
- Graduate Institute of Acupuncture Science, China Medical University, Taichung 404332, Taiwan
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12
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Zhang D, Huang X, Mao C, Chen Y, Miao Z, Liu C, Xu C, Wu X, Yin X. Assessment of normalized cerebral blood flow and its connectivity with migraines without aura during interictal periods by arterial spin labeling. J Headache Pain 2021; 22:72. [PMID: 34261444 PMCID: PMC8278584 DOI: 10.1186/s10194-021-01282-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migraine constitutes a global health burden, and its pathophysiology is not well-understood; research evaluating cerebral perfusion and altered blood flow between brain areas using non-invasive imaging techniques, such as arterial spin labeling, have been scarce. This study aimed to assess cerebral blood flow (CBF) and its connectivity of migraine. METHODS This study enrolled 40 patients with episodic migraine without aura (MwoA), as well as 42 healthy patients as control (HC). Two groups of normalized CBF and CBF connectivity were compared, and the relationship between CBF variation and clinical scale assessment was further evaluated. RESULTS In comparison to HC subjects, MwoA patients exhibited higher CBF in the right middle frontal orbital gyrus (ORBmid.R) and the right middle frontal gyrus, while that in Vermis_6 declined. The increased CBF of ORBmid.R was positively correlated with both the Visual Light Sensitivity Questionnaire-8 (VLSQ-8) and the monthly attack frequency score. In MwoA, significantly decreased CBF connectivity was detected between ORBmid.R and the left superior frontal gyrus, the right putamen, the right caudate, as well as the right angular gyrus. In addition, increased CBF connectivity was observed between the left calcarine cortex and ORBmid.R. CONCLUSIONS Our results indicate that migraine patients exhibit abnormalities in regional CBF and feature CBF connection defects at the resting state. The affected areas involve information perception, information integration, and emotional, pain and visual processing. Our findings might provide important clues for the pathophysiology of migraine.
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Affiliation(s)
- Di Zhang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Xiaobin Huang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Cunnan Mao
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Yuchen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Zhengfei Miao
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Chunmei Liu
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Chenjie Xu
- Department of Pain Treatment, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China
| | - Xinying Wu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China.
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, Jiangsu, China.
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13
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Wu X, Yu W, Tian X, Liang Z, Su Y, Wang Z, Li X, Yang L, Shen J. Altered Posterior Cerebellar Lobule Connectivity With Perigenual Anterior Cingulate Cortex in Women With Primary Dysmenorrhea. Front Neurol 2021; 12:645616. [PMID: 34239492 PMCID: PMC8258113 DOI: 10.3389/fneur.2021.645616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/21/2021] [Indexed: 11/22/2022] Open
Abstract
Objectives: This study aimed to investigate the potential connectivity mechanism between the cerebellum and anterior cingulate cortex (ACC) and the cerebellar structure in primary dysmenorrhea (PDM). Methods: We applied the spatially unbiased infratentorial template (SUIT) of the cerebellum to obtain anatomical details of cerebellar lobules, upon which the functional connectivity (FC) between the cerebellar lobules and ACC subregions was analyzed and the gray matter (GM) volume of cerebellar lobules was measured by using voxel-based morphometry (VBM) in 35 PDM females and 38 age-matched healthy females. The potential relationship between the altered FC or GM volume and clinical information was also evaluated in PDM females. Results: PDM females showed higher connectivity between the left perigenual ACC (pACC) and lobule vermis_VI, between the left pACC and left lobule IX, and between right pACC and right cerebellar lobule VIIb than did the healthy controls. Compared with healthy controls, no altered GM volume was found in PDM females. No significant correlation was found between altered cerebellum–ACC FC and the clinical variables in the PDM females. Conclusion: PDM females have abnormal posterior cerebellar connectivity with pACC but no abnormal structural changes. ACC–cerebellar circuit disturbances might be involved in the PDM females.
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Affiliation(s)
- Xiaoyan Wu
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,School of Psychology, South China Normal University, Guangzhou, China
| | - Wenjun Yu
- Precise Genome Engineering Center, School of Life Sciences, Guangzhou University, Guangzhou, China.,School of Education, Jinggangshan University, Jiangxi, China
| | - Xuwei Tian
- Department of Radiology, First People's Hospital of Kashgar, Xinjiang, China
| | - Zhiying Liang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yun Su
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhihui Wang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiumei Li
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Li Yang
- Precise Genome Engineering Center, School of Life Sciences, Guangzhou University, Guangzhou, China
| | - Jun Shen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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14
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Wang Y, Xu J, Zhang Q, Zhang Q, Yang Y, Wei W, Guo X, Liang F, Yu S, Yang J. Immediate Analgesic Effect of Acupuncture in Patients With Primary Dysmenorrhea: A fMRI Study. Front Neurosci 2021; 15:647667. [PMID: 34108856 PMCID: PMC8180846 DOI: 10.3389/fnins.2021.647667] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/16/2021] [Indexed: 01/22/2023] Open
Abstract
Primary dysmenorrhea (PDM) is a common gynecological disease characterized by lower abdominal pain. Acupuncture is considered a good alternative therapy for PDM. However, the central mechanism of the analgesic effect of acupuncture is largely unknown. In this study, eligible patients were randomized into the real and sham acupuncture groups using a computer-generated, permuted block randomization method. The study cohort comprised 34 patients: 19 in the real acupuncture group and 15 in the sham acupuncture group. The clinical characteristics of the patients during their menstrual period were collected, and imaging scans were performed during the first 3 days of the patients' menstrual period. We analyzed task and resting functional magnetic resonance imaging (fMRI) data to investigate the potential central mechanism of the immediate effect of acupuncture intervention on the intensity of PDM pain. The task fMRI study found that the rostral anterior cingulate cortex (rACC) and right supplemental motor area were activated during real acupuncture. Using the resting-state functional connectivity (FC) method, we found a post- versus pre-treatment change in the FC of the rACC and left precentral gyrus in the comparison of real acupuncture versus sham acupuncture. In addition, the FC of the rACC-left precentral gyrus at baseline was negatively correlated with short-term analgesia, while the change in the FC of the rACC-left precentral gyrus was positively correlated with short-term analgesia after acupuncture treatment. These findings support the importance of rACC-left precentral gyrus resting-state FC in the modulation of the intensity of PDM pain through acupuncture, which may shed light on the central mechanism of acupuncture in the treatment of PDM.
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Affiliation(s)
- Yanan Wang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Xu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qing Zhang
- People’s Hospital of Yuxi City, Yuxi, China
| | - Qi Zhang
- Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Ya Yang
- Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Wei Wei
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoli Guo
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fanrong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Siyi Yu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jie Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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15
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Wu X, Yu W, Hu H, Su Y, Liang Z, Bai Z, Tian X, Yang L, Shen J. Dynamic network topological properties for classifying primary dysmenorrhoea in the pain-free phase. Eur J Pain 2021; 25:1912-1924. [PMID: 34008281 DOI: 10.1002/ejp.1808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Primary dysmenorrhoea (PDM) is known to alter brain static functional activity. This study aimed to explore the dynamic topological properties (DTP) of dynamic brain functional network in women with PDM in the pain-free phase and their performance in distinguishing PDM in the pain-free phase from healthy controls. METHODS Thirty-five women with PDM and 38 healthy women without PDM were included. A dynamic brain functional network was constructed using the slide-window approach. The stability (TP-Stab) and variability (TP-Var) of the DTP of the dynamic functional network were computed using the graph-theory method. A support vector machine (SVM) was used to evaluate the performance of DTP in identifying PDM in the pain-free phase. RESULTS Compared with healthy controls, women with PDM had not only lower TP-Stab in global DTP, which included cluster clustering coefficient (Cp ), characteristic path length (Lp ), global efficiency (Eg ) and local efficiency (Eloc ), but also lower TP-Stab and higher TP-Var in nodal DTP (nodal efficiency, Enod ), mainly in the prefrontal cortex, anterior cingulate cortex, parahippocampal regions and insula. The TP-Stab and TP-Var were significantly correlated with psychological variables, that is positive emotions, sense of control and meaningful existence. SVM analysis showed that the DTP could identify PDM in the pain-free phase from healthy controls with an accuracy of 79.31%, sensitivity of 82.61% and specificity of 76%. CONCLUSIONS Women with PDM in the pain-free phase have altered global DTP and nodal DTP, mainly involving pain-related neurocircuits. The highly variable brain network is helpful for identifying PDM in the pain-free phase. SIGNIFICANCE This study shows that women with primary dysmenorrhoea (PDM) have decreased stability of dynamic network topological properties (DTP) and increased DTP variability in the pain-free phase. The altered DTP can be used to identify PDM in the pain-free phase. These findings demonstrate the presence of unstable characteristics in the whole network and disrupted pain-related neurocircuits, which might be used as potential classifiers for PDM in the pain-free phase. This study improves our knowledge of the brain mechanisms underlying PDM.
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Affiliation(s)
- Xiaoyan Wu
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,School of Psychology, South China Normal University, Guangzhou, China
| | - Wenjun Yu
- Precise Genome Engineering Center, School of Life Sciences, Guangzhou University, Guangzhou, China.,School of Education, Jinggangshan University, Jiangxi, China
| | - Huijun Hu
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yun Su
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhiying Liang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhiqiang Bai
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xuwei Tian
- Department of Radiology, First People's Hospital of Kashgar, Xinjiang, China
| | - Li Yang
- Precise Genome Engineering Center, School of Life Sciences, Guangzhou University, Guangzhou, China
| | - Jun Shen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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16
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Aberrant resting-state cerebral blood flow and its connectivity in primary dysmenorrhea on arterial spin labeling MRI. Magn Reson Imaging 2020; 73:84-90. [PMID: 32750444 DOI: 10.1016/j.mri.2020.07.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 07/25/2020] [Accepted: 07/30/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to clarify the resting-state cerebral blood flow alteration patterns induced by primary dysmenorrhea, investigate the relationships between cerebral blood flow alterations and clinical parameters of patients with primary dysmenorrhea, and explore whether brain regions with abnormal cerebral blood flow also feature functional connectivity changes. METHODS Arterial spin labeling imaging and clinical parameters were acquired in 42 patients with primary dysmenorrhea and 41 healthy controls during their menstrual phases. Differences in cerebral blood flow were compared between the two groups, and the clusters with significant group differences were selected as the regions of interest for further statistical analyses. RESULTS Compared to healthy controls, patients with primary dysmenorrhea exhibited increased cerebral blood flow in the bilateral precuneus, left posterior cingulate cortex, and right rolandic operculum. Among patients with primary dysmenorrhea, we identified a negative correlation between the cerebral blood flow in the right rolandic operculum and the visual analogue score for anxiety, and greater correlation between the functional connectivity in the precuneus/posterior cingulate cortex and the right middle cingulate cortex, and between the right rolandic operculum and the left inferior parietal lobule and the bilateral postcentral gyrus. DISCUSSION Cerebral blood flow abnormalities associated with primary dysmenorrhea were mainly concentrated in the areas comprising the default mode network in primary dysmenorrhea patients, which could be involved in the central mechanism of primary dysmenorrhea. Cerebral blood flow alteration in the rolandic operculum may underlie an anxiety-induced compulsive tendency in patients with primary dysmenorrhea. Investigating the enhanced connectivity among various pain-related brain regions could improve understanding of the onset and development of primary dysmenorrhea.
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17
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The medial temporal lobe in nociception: a meta-analytic and functional connectivity study. Pain 2020; 160:1245-1260. [PMID: 30747905 DOI: 10.1097/j.pain.0000000000001519] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Recent neuroimaging studies implicate the medial temporal lobe (MTL) in nociception and pain modulation. Here, we aim to identify which subregions of the MTL are involved in human pain and to test its connectivity in a cohort of chronic low-back pain patients (CBP). We conducted 2 coordinate-based meta-analyses to determine which regions within the MTL showed consistent spatial patterns of functional activation (1) in response to experimental pain in healthy participants and (2) in chronic pain compared with healthy participants. We followed PRISMA guidelines and performed activation likelihood estimate (ALE) meta-analyses. The first meta-analysis revealed consistent activation in the right anterior hippocampus (right antHC), parahippocampal gyrus, and amygdala. The second meta-analysis revealed consistently less activation in patients' right antHC, compared with healthy participants. We then conducted a seed-to-voxel resting state functional connectivity of the right antHC seed with the rest of the brain in 77 CBP and 79 age-matched healthy participants. We found that CBP had significantly weaker antHC functional connectivity to the medial prefrontal cortex compared with healthy participants. Taken together, these data indicate that the antHC has abnormally lower activity in chronic pain and reduced connectivity to the medial prefrontal cortex in CBP. Future studies should investigate the specific role of the antHC in the development and management of chronic pain.
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18
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Liu S, Wang L, Yang J. Instant analgesic effect of radial extracorporeal shock wave therapy on primary dysmenorrhoea according to functional magnetic resonance imaging: study protocol for a randomised placebo-controlled trial. Trials 2020; 21:164. [PMID: 32046753 PMCID: PMC7014766 DOI: 10.1186/s13063-020-4045-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/01/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Primary dysmenorrhoea (PDM) is defined as a series of pain-dominated symptoms during and after menstruation without organic lesions. Nonsteroidal anti-inflammatory drugs and oral contraceptives are usually recommended as first-line therapy for the clinical treatment of PDM, but their widespread long-term application is controversial. Radial extracorporeal shock wave therapy (rESWT) has been widely applied in musculoskeletal rehabilitation because of its secure and noninvasive characteristics and its confirmed effect in improving pain symptoms. This research seeks to explore the efficacy of rESWT for PDM and the changes in brain function of patients with PDM. METHODS This clinical research will be a randomised, blind, sham-controlled trial. Thirty-six patients with PDM will be randomly divided into the rESWT group (n = 18) and the sham rESWT group (n = 18). In the rESWT group, treatment will be applied once within 48 h of menstruation at six abdominal myofascial trigger points. The sham rESWT group will receive sham shockwave therapy on the same sites but without energy input. Other dysmenorrhoea-related treatments in both groups will be limited. The main indicators include the short form of the McGill Pain Questionnaire and the Cox Menstrual Symptom Scale. The secondary indicators include the Zung Self-rating Anxiety Scale and Self-rating Depression Scale and functional magnetic resonance imaging (fMRI) changes in brain regions. Results will be evaluated at the screening, at baseline, and before and after treatment, and adverse treatments will be examined. Inter- and intragroup analyses will be performed. DISCUSSION This randomised controlled study is designed to explore the immediate efficacy of rESWT for PDM. After rESWT treatment, PDM symptom tests and pain tests, as well as fMRI data, will be investigated for the potential connections between immediate neuroanalgesic mechanisms, which are associated with pain and brain networks. The main results will be used to assess the efficacy of rESWT, and secondary results will focus on improving the neurobiological understanding of disease treatment. TRIAL REGISTRATION China Clinical Trial Register, ChiCTR1900020678. Registered on 13 January 2019.
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Affiliation(s)
- Shanshan Liu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Lezheng Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Jian Yang
- Department of Rehabilitation, Shanghai Xuhui Central Hospital / Zhongshan-Xuhui Hospital, Fudan University / Shanghai Clinical Research Center, Chinese Academy of Sciences, 966 Middle Huaihai Road, Shanghai, 200031, China.
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19
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Zhang YN, Huo JW, Huang YR, Hao Y, Chen ZY. Altered amplitude of low-frequency fluctuation and regional cerebral blood flow in females with primary dysmenorrhea: a resting-state fMRI and arterial spin labeling study. J Pain Res 2019; 12:1243-1250. [PMID: 31114306 PMCID: PMC6489567 DOI: 10.2147/jpr.s177502] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 02/14/2019] [Indexed: 12/12/2022] Open
Abstract
Purpose: The current study aimed to explore the central mechanism of primary dysmenorrhea (PD) by investigating the alterations in resting state amplitude of low-frequency fluctuation (ALFF) and regional cerebral blood flow (CBF) between PD patients and healthy controls (HCs). Patients and methods: A total of 34 female subjects including 20 PD patients and 14 HCs underwent resting-state functional magnetic resonance imaging (rs-fMRI) and arterial spin labeling technique (ASL) MRI during menstrual phase. Subsequently, the differences in ALFF and CBF were compared in the two groups. The visual analog scores for pain (VAS-P) and for anxiety (VAS-A) were applied to assess cramping pain and related symptoms in PD patients. Finally, Pearson's correlation analysis was performed to analyze relationships between the neuroimaging findings and clinical characteristics. Results: Compared to HCs, PD patients had decreased ALFF in the right cerebellum posterior lobe, right middle temporal gyrus, right parahippocampal gyrus, right hippocampus, right brainstem and left parietal lobe. In addition, elevated CBF values were observed in the right inferior frontal gyrus, right precentral gyrus, and right superior temporal gyrus. There was no significant correlation between ALFF, CBF values and clinical characteristics including onset age of dysmenorrhea, VAS-A, and VAS-P in PD patients. Conclusion: The preliminary alterations of ALFF and CBF values in PD patients were observed in different pain-related brain regions, which were involved in multiple dimensions of pain and pain modulation. The combination of rs-fMRI and ASL MRI might provide complementary information for a better understanding of the central mechanism in PD.
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Affiliation(s)
- Ya-Nan Zhang
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing100010, People’s Republic of China
| | - Jian-Wei Huo
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing100010, People’s Republic of China
| | - Yi-Ran Huang
- School of Acupuncture-Moxibustion & Tuina, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China
| | - Ying Hao
- Beijing International Center for Mathematical Research, Peking University, Beijing100871, People’s Republic of China
| | - Zi-Yue Chen
- Department of Acupuncture and Moxibustion, Yanshan Hospital, Beijing102500, People’s Republic of China
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20
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Lee LC, Chen YH, Lin CS, Li WC, Low I, Tu CH, Chou CC, Cheng CM, Yeh TC, Chen LF, Chao HT, Hsieh JC. Unaltered intrinsic functional brain architecture in young women with primary dysmenorrhea. Sci Rep 2018; 8:12971. [PMID: 30154419 PMCID: PMC6113269 DOI: 10.1038/s41598-018-30827-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 08/02/2018] [Indexed: 01/03/2023] Open
Abstract
Primary dysmenorrhea (PDM), painful menstruation without organic causes, is the most prevalent gynecological problem in women of reproductive age. Dysmenorrhea later in life often co-occurs with many chronic functional pain disorders, and chronic functional pain disorders exhibit altered large-scale connectedness between distributed brain regions. It is unknown whether the young PDM females exhibit alterations in the global and local connectivity properties of brain functional networks. Fifty-seven otherwise healthy young PDM females and 62 age- and education-matched control females participated in the present resting-state functional magnetic resonance imaging study. We used graph theoretical network analysis to investigate the global and regional network metrics and modular structure of the resting-state brain functional networks in young PDM females. The functional network was constructed by the interregional functional connectivity among parcellated brain regions. The global and regional network metrics and modular structure of the resting-state brain functional networks were not altered in young PDM females at our detection threshold (medium to large effect size differences [Cohen's d ≥ 0.52]). It is plausible that the absence of significant changes in the intrinsic functional brain architecture allows young PDM females to maintain normal psychosocial outcomes during the pain-free follicular phase.
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Affiliation(s)
- Lin-Chien Lee
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Yueh-Hua Chen
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Shu Lin
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chi Li
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Intan Low
- Institute of Biomedical Informatics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Hao Tu
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Chih-Che Chou
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chou-Ming Cheng
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzu-Chen Yeh
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-Fen Chen
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Biomedical Informatics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsiang-Tai Chao
- Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jen-Chuen Hsieh
- Institute of Brain Science, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
- Integrated Brain Research Unit, Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.
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