Changes of functional connectivity of the anterior cingulate cortex in women with primary dysmenorrhea

Abstract

Primary dysmenorrhea (PDM), a common gynecological disorder, is associated with structural and functional alterations in several subregions of the anterior cingulate cortex (ACC). However, systematic functional connectivity of the ACC subregions in PDM has not been clarified. In this study, we used resting-state functional magnetic resonance imaging (fMRI) data from forty-eight PDM patients and thirty-eight matched female healthy controls to investigate the functional connectivity of ACC subregions in PDM. Compared to healthy controls, PDM patients exhibited increased connectivity between the caudal ACC (cACC) and primary somatosensory cortex (SI), between the perigenual ACC (pACC) and caudate, and between the subgenual ACC (sACC) and medial prefrontal cortex (mPFC). PDM patients also showed decreased connectivity between the pACC and precuneus. In PDM group, the connectivity of the right pACC-right caudate positively correlated with disease duration, and the connectivity of the left pACC-left precuneus negatively correlated with disease severity. These present findings reveal that abnormal ACC connectivity may be implicated in the PDM-related disturbances in pain sensory, modulation, and affection. We hope that our study could enhance the understanding of the pathophysiology underlying PDM.

Resting-State Functional Connectivity Patterns Predict Acupuncture Treatment Response in Primary Dysmenorrhea

“…PDM has been proposed to be part of the central sensitization syndromes together with several chronic pain conditions, including fibromyalgia, irritable bowel syndrome, idiopathic low back pain, headache and migraine ( Yunus, 2012 ; Iacovides et al, 2015 ). In recent years, using neuroimaging techniques, our group ( Shen et al, 2019 ; Zhang et al, 2019 ) and other groups ( Tu et al, 2009 ; Liu et al, 2018 ; Chen et al, 2019 ) have confirmed that PDM is associated with significant changes in the central nervous system’s anatomy, metabolism, and resting-state function. Although the exact mechanisms of the analgesic effects of acupuncture are not known, studies have postulated that acupuncture can alleviate pain by modulating brain regions and networks associated with pain processing ( Chen et al, 2015 ; Maeda et al, 2017 ).…”

Behavioural and neural responses to aversive visceral stimuli in women with primary dysmenorrhoea

“…It is indeed conceivable that as in IBS, alterations in the neural processing of visceral stimuli or in brain functional connectivity in PDM are shaped by the presence of visceral hypersensitivity (Icenhour et al., ; Larsson et al., ), which may not characterize all patients but only specific subgroups. This is underlined by comparatively large brain imaging studies in PDM patients revealing alterations of structure and functional connectivity (Liu et al., ) in the periaqueductal grey in association with a genetic polymorphism of the brain derived neurotrophic factor (BDNF), a known pain modulator in regards to adaptive neuroplasticity (Wei, Chao, Tu, Li et al., ; Wei, Chao, Tu, Lin et al., ).…”

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

“…Third, a healthy group should not be used as a control group. Previous literature has shown differences in the brain networks of patients with PDM and healthy participants [27,28]. Conversely, our study will focus on the functional brain changes that will be confirmed by extracorporeal shock wave rather than the PDM-specific features against healthy controls.…”