Changes in regional gray matter volume in women with chronic pelvic pain: A voxel-based morphometry study
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- 1 May 2012
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Pain
- Vol. 153 (5), 1006-1014
- https://doi.org/10.1016/j.pain.2012.01.032
Abstract
Summary Chronic pelvic pain, with and without endometriosis, is associated with changes in regional gray matter volume within the central pain system. ABSTRACT Chronic pelvic pain (CPP) is a highly prevalent pain condition, estimated to affect 15%–20% of women in the United States. Endometriosis is often associated with CPP, however, other factors, such as preexisting or concomitant changes of the central pain system, might contribute to the development of chronic pain. We applied voxel-based morphometry to determine whether women with CPP with and without endometriosis display changes in brain morphology in regions known to be involved in pain processing. Four subgroups of women participated: 17 with endometriosis and CPP, 15 with endometriosis without CPP, 6 with CPP without endometriosis, and 23 healthy controls. All patients with endometriosis and/or CPP were surgically confirmed. Relative to controls, women with endometriosis-associated CPP displayed decreased gray matter volume in brain regions involved in pain perception, including the left thalamus, left cingulate gyrus, right putamen, and right insula. Women with CPP without endometriosis also showed decreases in gray matter volume in the left thalamus. Such decreases were not observed in patients with endometriosis who had no CPP. We conclude that CPP is associated with changes in regional gray matter volume within the central pain system. Although endometriosis may be an important risk factor for the development of CPP, acting as a cyclic source of peripheral nociceptive input, our data support the notion that changes in the central pain system also play an important role in the development of chronic pain, regardless of the presence of endometriosis.Keywords
Funding Information
- NIH Building Interdisciplinary Research in Women’s Health (K12HD001438, NIH UL1RR024986)
- Bayer Droegemueller Award in Clinical Research (NIH R01-AR050044, DAMD 17-00-2-0018)
- DFG
- Dana Foundation and the Department of Defense (DAMD-W81XWH-07-2-0050)
- NCCAM (R01-AT004714, P01-AT002048)
This publication has 44 references indexed in Scilit:
- Brain Functional and Anatomical Changes in Chronic Prostatitis/Chronic Pelvic Pain SyndromeJournal of Urology, 2011
- Chronic pelvic pain and endometriosis: translational evidence of the relationship and implicationsHuman Reproduction Update, 2010
- Regional Gray Matter Density Changes in Brains of Patients With Irritable Bowel SyndromeGastroenterology, 2010
- Altered Brain Structure in Irritable Bowel Syndrome: Potential Contributions of Pre-Existing and Disease-Driven FactorsGastroenterology, 2010
- Chronic myofascial temporomandibular pain is associated with neural abnormalities in the trigeminal and limbic systemsPain, 2010
- Abnormal cerebral metabolism during menstrual pain in primary dysmenorrheaNeuroImage, 2009
- Impaired small-world efficiency in structural cortical networks in multiple sclerosis associated with white matter lesion loadBrain, 2009
- Changes in brain gray matter due to repetitive painful stimulationNeuroImage, 2008
- Evidence of augmented central pain processing in idiopathic chronic low back painArthritis & Rheumatism, 2004
- The CES-D ScaleApplied Psychological Measurement, 1977