Dynamic Changes of Functional Pain Connectome in Women with Primary Dysmenorrhea.
Dynamic Changes of Functional Pain Connectome in Women with Primary Dysmenorrhea.
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DOI：
10.1038/srep24543
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发表时间：
2016-04-19
影响因子：
4.6
通讯作者：
Hsieh JC
中科院分区：
文献类型：
--
作者：
Wu TH;Tu CH;Chao HT;Li WC;Low I;Chuang CY;Yeh TC;Cheng CM;Chou CC;Chen LF;Hsieh JC
原发性痛经（PDM）是最常见的妇科问题。许多关键的大脑系统参与疼痛处理。鉴于系统（或网络）内部和之间在形成疼痛体验和行为方面的动态交流，系统中心区域的区域内功能连接（FC）可能被改变，网络之间区域间FC的功能相互作用可能被重组，以应对PDM中反复出现的月经疼痛压力。纳入46名健康的PDM受试者和49名年龄匹配的健康女性对照受试者。区域内FC和区域间FC分别采用区域均匀性（ReHo）和ReHo种子FC分析进行评估。PDM女性在排卵期表现出与特征相关的腹内侧前额叶皮层（默认模式网络（DMN）的一部分）ReHo减少。月经周期中与特征相关的dmn -显著性网络的低连通性和dmn -执行控制网络的超连通性表现出从疼痛显著性的情感加工到认知调节的动态转变。dmn -感觉运动网络的改变可能是经期累积疼痛的持续表现。研究结果表明，患有长期PDM的女性可能会发展适应性神经可塑性和功能重组，其网络从显著性的情感加工转变为疼痛的认知调节。
Primary dysmenorrhea (PDM) is the most prevalent gynecological problem. Many key brain systems are engaged in pain processing. In light of dynamic communication within and between systems (or networks) in shaping pain experience and behavior, the intra-regional functional connectivity (FC) in the hub regions of the systems may be altered and the functional interactions in terms of inter-regional FCs among the networks may be reorganized to cope with the repeated stress of menstrual pain in PDM. Forty-six otherwise healthy PDM subjects and 49 age-matched, healthy female control subjects were enrolled. Intra- and inter-regional FC were assessed using regional homogeneity (ReHo) and ReHo-seeded FC analyses, respectively. PDM women exhibited a trait-related ReHo reduction in the ventromedial prefrontal cortex, part of the default mode network (DMN), during the periovulatory phase. The trait-related hypoconnectivity of DMN-salience network and hyperconnectivity of DMN-executive control network across the menstrual cycle featured a dynamic transition from affective processing of pain salience to cognitive modulation. The altered DMN-sensorimotor network may be an ongoing representation of cumulative menstrual pain. The findings indicate that women with long-term PDM may develop adaptive neuroplasticity and functional reorganization with a network shift from affective processing of salience to the cognitive modulation of pain.