The posterior medial cortex in urologic chronic pelvic pain syndrome: detachment from default mode network-a resting-state study from the MAPP Research Network

被引:52
作者
Martucci, Katherine T. [1 ]
Shirer, William R. [2 ]
Bagarinao, Epifanio [1 ]
Johnson, Kevin A. [1 ]
Farmer, Melissa A. [3 ]
Labus, Jennifer S. [4 ]
Apkarian, A. Vania [3 ]
Deutsch, Georg [5 ]
Harris, Richard E. [6 ]
Mayer, Emeran A. [4 ]
Clauw, Daniel J. [6 ]
Greicius, Michael D. [2 ]
Mackey, Sean C. [1 ]
机构
[1] Stanford Univ, Div Pain Med, Dept Anesthesiol Perioperat & Pain Med, Stanford, CA 94305 USA
[2] Stanford Univ, Dept Neurol & Neurol Sci, Stanford, CA 94305 USA
[3] Northwestern Univ, Dept Physiol, Chicago, IL 60611 USA
[4] Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, Dept Med, Los Angeles, CA 90095 USA
[5] Univ Alabama Birmingham, Dept Radiol, Birmingham, AL USA
[6] Univ Michigan, Dept Anesthesiol, Ann Arbor, MI 48109 USA
基金
美国国家卫生研究院;
关键词
UCPPS; Interstitial cystitis; Bladder pain syndrome; Posterior cingulate cortex; Default mode network; DMN; Precuneus; Dual regression; Resting state; fMRI; LOW-BACK-PAIN; CYSTITIS/PAINFUL BLADDER SYNDROME; INTRINSIC BRAIN CONNECTIVITY; FUNCTIONAL CONNECTIVITY; ALZHEIMERS-DISEASE; CLINICAL PAIN; GRAY-MATTER; WOMEN; MRI; FIBROMYALGIA;
D O I
10.1097/j.pain.0000000000000238
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Altered resting-state (RS) brain activity, as a measure of functional connectivity (FC), is commonly observed in chronic pain. Identifying a reliable signature pattern of altered RS activity for chronic pain could provide strong mechanistic insights and serve as a highly beneficial neuroimaging-based diagnostic tool. We collected and analyzed RS functional magnetic resonance imaging data from female patients with urologic chronic pelvic pain syndrome (N = 45) and matched healthy participants (N 5 45) as part of an NIDDK-funded multicenter project (www.mappnetwork.org). Using dual regression and seed-based analyses, we observed significantly decreased FC of the default mode network to 2 regions in the posterior medial cortex (PMC): the posterior cingulate cortex (PCC) and the left precuneus (threshold-free cluster enhancement, family-wise error corrected P < 0.05). Further investigation revealed that patients demonstrated increased FC between the PCC and several brain regions implicated in pain, sensory, motor, and emotion regulation processes (eg, insular cortex, dorsolateral prefrontal cortex, thalamus, globus pallidus, putamen, amygdala, hippocampus). The left precuneus demonstrated decreased FC to several regions of pain processing, reward, and higher executive functioning within the prefrontal (orbitofrontal, anterior cingulate, ventromedial prefrontal) and parietal cortices (angular gyrus, superior and inferior parietal lobules). The altered PMC connectivity was associated with several phenotype measures, including pain and urologic symptom intensity, depression, anxiety, quality of relationships, and self-esteem levels in patients. Collectively, these findings indicate that in patients with urologic chronic pelvic pain syndrome, regions of the PMC are detached from the default mode network, whereas neurological processes of self-referential thought and introspection may be joined to pain and emotion regulatory processes.
引用
收藏
页码:1755 / 1764
页数:10
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