The ALFF Alterations of Spontaneous Pelvic Pain in the Patients of Chronic Prostatitis/Chronic Pelvic Pain Syndrome Evaluated by fMRI

Abstract

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a challenging entity with complicated symptoms for treatment in the male crowd. Accumulating evidence revealed the dysfunction in the central system should be a critical factor for the pathogenesis and development in the CP/CPPS. Therefore, we recruited 20 patients of CP/CPPS and 20 healthy male volunteers, aged 20 to 50 years. Through resting-state functional magnetic resonance imaging (fMRI), we analyzed the mean amplitude of low-frequency fluctuations (mALFF) and the mean fractional amplitude of low-frequency fluctuations (mfALFF) to reflect the spontaneous abnormal activated regions in the brains of CP/CPPS patients. Compared to the healthy controls, the group with CP/CPPS had significantly increased mALFF values in the thalamus and augmented fALFF values in the inferior parietal lobule and cingulate gyrus. Significant positive correlations were observed in the extracted mALFF values in the midbrain periaqueductal gray matter (PAG) and the pain intensity (r = 0.2712, p = 0.0019), mALFF values in the thalamus and the scores of Hospital Anxiety and Depression Scale (HADS) anxiety subscale (r = 0.08477, p = 0.0461), and mfALFF values in the superior frontal gyrus (SFG) and the scores of the HADS anxiety subscale (r = 0.07102, p = 0.0282). Therefore, we delineated the clinical alterations in patients of CP/CPPS that might be attributed to the functional abnormality of the thalamus, inferior parietal lobule, and cingulate gyrus. Among these regions, the PAG, thalamus, and SFG may further play an important role in the pathogenesis, with their regulating effect on pain or emotion.

Deficits in the thalamocortical pathway associated with hypersensitivity to pain in patients with frozen shoulder

“…These non-invasive and objective methods of brain functional measurement have been proven to be invaluable in gaining a deeper understanding of pain sensitization mechanisms in patient populations and for exploring analgesic targets ( 20 ). Furthermore, research studies have revealed regional functional abnormalities [amplitude of low-frequency fluctuation and regional homogeneity ( 21 – 23 )], alterations in the pain modulation pathway [e.g., pain ascending/descending pathway ( 24 )], and network reorganizations [e.g., default mode network and saliency network ( 25 , 26 )], which were associated with pain hypersensitivity in various chronic pain conditions. While previous studies have identified brain neuropathological changes in chronic pain patients, the central mechanisms of pain are yet to be studied in depth in FS.…”

Abnormal brain activity in lumbar disc herniation patients with chronic pain is associated with their clinical symptoms

“…Among fMRI analysis methods, ALFF can directly reflect the magnitude of baseline changes in the brain blood oxygen level-dependent effect (BOLD) signal and indirectly indicate the intensity of local neuronal spontaneous activity in the brain. ALFF is considered to be one of the most common methods for observing changes in brain function at rest and is widely used in brain function studies of pain-related diseases (Zang, 2016;Du et al, 2018;Pan et al, 2018;Ge et al, 2022). Therefore, we used a data-driven ALFF analysis to explore differences in brain activity between patients with lumbar disc herniation chronic low back pain (LDHCP) and healthy controls (HCs).…”