Spectral Clustering Reveals Different Profiles of Central Sensitization in Women with Carpal Tunnel Syndrome

Pellicer-Valero, Óscar J.; Martín-Guerrero, José D.; Fernández‐de‐las‐Peñas, César; de-la-Llave-Rincón, Ana I; Rodríguez‐Jiménez, Jorge; Navarro‐Pardo, Esperanza; Cigarán‐Méndez, Margarita

doi:10.3390/sym13061042

Cited by 3 publications

(2 citation statements)

References 38 publications

(44 reference statements)

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“…Central sensitization has been linked to worse short-term treatment outcomes in carpal tunnel syndrome. 14 Quantitative sensory testing (QST) has identified multiple sensory phenotypes of carpal tunnel syndrome comprising thermal or mechanical hyperalgesia and sensory loss, 15 , 16 which likely reflects heterogeneity in underlying nerve pathology and corresponding neuroplasticity throughout the somatosensory system.…”

Section: Introductionmentioning

confidence: 99%

Carpal tunnel surgery dampens thalamocortical and normalizes corticocortical functional connectivity

Osborne

Anastakis

Kim

et al. 2022

Brain Communications

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Carpal tunnel syndrome is the most common entrapment neuropathy and is associated with altered brain function and structure. However, little is understood of the central mechanisms associated with its pain, symptom presentation and treatment-related resolution. This longitudinal study evaluated carpal tunnel syndrome-related alterations in brain network communication and relationships to behavioural signs of central sensitization before and after carpal tunnel release surgery. We tested the hypothesis that carpal tunnel syndrome is associated with condition- and treatment-related plasticity in brain regions involved in somatosensation. We used quantitative sensory testing and clinical and pain questionnaires to assess sensory and pain function in 25 patients with carpal tunnel syndrome before (18 women, 7 men) and after (n = 16) surgery, and 25 sex- and age-matched healthy controls. We also acquired resting state functional MRI to determine functional connectivity of two key nodes in the somatosensory system, the thalamus and primary somatosensory cortex. Seed-to-whole brain static resting state static functional connectivity analyses revealed abnormally low functional connectivity for the hand area of the primary somatosensory cortex with the contralateral somatosensory association cortex (supramarginal gyrus) before surgery (P < 0.01). After clinically effective surgery: 1) Primary somatosensory functional connectivity was normalized with the contralateral somatosensory association cortex, and reduced with the dorsolateral prefrontal cortex (a region associated with cognitive and emotional modulation of pain) and primary visual areas (P < 0.001) from pre-op levels; and 2) Functional connectivity of the thalamus with the primary somatosensory and motor cortices was attenuated from pre-op levels (P < 0.001), but did not correlate with temporal summation of pain (a behavioural measure of central sensitization) or clinical measures. This study is the first to reveal treatment-related neuroplasticity in resting state functional connectivity of the somatosensory system in carpal tunnel syndrome. The findings of dysfunctional resting state functional connectivity point to aberrant neural synchrony between the brain’s representation of the hand with regions involved in processing and integrating tactile and nociceptive stimuli and proprioception in carpal tunnel syndrome. Aberrant neural communication between the primary somatosensory hand area and the dorsolateral prefrontal cortex could reflect increased attention to pain, paraesthesia and altered sensation in the hand. Finally, reduced thalamocortical functional connectivity after surgery may reflect central plasticity in response to the resolution of abnormal sensory signals from the periphery. Our findings support the concept of underlying brain contributions to this peripheral neuropathy, specifically aberrant thalamocortical and corticocortical communication, and point to potential central therapeutic targets to complement peripheral treatments.

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Section: Introductionmentioning

confidence: 99%

Carpal tunnel surgery dampens thalamocortical and normalizes corticocortical functional connectivity

Osborne

Anastakis

Kim

et al. 2022

Brain Communications

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“…The first article is "Spectral Clustering Reveals Different Profiles of Central Sensitization in Women with Carpal Tunnel Syndrome (CTS)" [1]. CTS is considered to be one of the most prevalent entrapment neuropathies of the upper extremities.…”

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confidence: 99%

Editorial of Special Issue “Application of Mathematical Modelling and Symmetry in Neuroscience”

Navarro‐Pardo

2022

Symmetry

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Clustering analysis identifies two subgroups of women with fibromyalgia with different psychological, cognitive, health-related, and physical features but similar widespread pressure pain sensitivity

Fernández‐de‐las‐Peñas

Valera‐Calero

Arendt‐Nielsen

et al. 2022

Pain Medicine

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Objective Since identification of groups of patients can help to better understand risk factors related to each group and to improve personalized therapeutic strategies, this study aimed to identify subgroups (clusters) of women with fibromyalgia syndrome (FMS) according to pain-related, related-disability, neuro-physiological, cognitive, health-related, psychological or physical features. Methods Demographic, pain-related, sensory-related, related-disability, psychological, health-related, cognitive, and physical variables were collected in 113 women with FMS. Widespread pressure pain thresholds (PPTs) were also assessed. K-means clustering was used to identify groups of women without any previous assumption. Results Two clusters exhibiting similar widespread sensitivity to pressure pain (PPTs) but differing in the remaining variables were identified. Overall, women in one cluster exhibited higher pain intensity and related-disability, more sensitization-associated and neuropathic pain symptoms, higher kinesiophobia, hypervigilance and catastrophism levels, worse sleep quality, higher anxiety/depressive levels, lower health-related function, and worse physical function than women in the other cluster. Conclusions Cluster analysis identified one group of women with FMS exhibiting worse sensory, psychological, cognitive and health-related features. Widespread sensitivity to pressure pain seems to be a common feature of FMS. Current results suggest that this group of women with FMS may need to be treated differently.

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Spectral Clustering Reveals Different Profiles of Central Sensitization in Women with Carpal Tunnel Syndrome

Cited by 3 publications

References 38 publications

Carpal tunnel surgery dampens thalamocortical and normalizes corticocortical functional connectivity

Carpal tunnel surgery dampens thalamocortical and normalizes corticocortical functional connectivity

Editorial of Special Issue “Application of Mathematical Modelling and Symmetry in Neuroscience”

Clustering analysis identifies two subgroups of women with fibromyalgia with different psychological, cognitive, health-related, and physical features but similar widespread pressure pain sensitivity

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