TY - JOUR
T1 - The posterior medial cortex in urologic chronic pelvic pain syndrome
T2 - Detachment from default mode network - A resting-state study from the MAPP Research Network
AU - Martucci, Katherine T.
AU - Shirer, William R.
AU - Bagarinao, Epifanio
AU - Johnson, Kevin A.
AU - Farmer, Melissa A.
AU - Labus, Jennifer S.
AU - Apkarian, A. Vania
AU - Deutsch, Georg
AU - Harris, Richard E.
AU - Mayer, Emeran A.
AU - Clauw, Daniel J.
AU - Greicius, Michael D.
AU - Mackey, Sean C.
N1 - Funding Information:
Funding for the MAPP Research Network was obtained under a cooperative agreement from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH) (DK82370, DK82342, DK82315, DK82344, DK82325, DK82345, DK82333, and DK82316). This study was supported by additional NIH grants (K24 DA29262, T32 GM89626) and the Redlich Pain Research Endowment.
Publisher Copyright:
© 2015 International Association for the Study of Pain.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Altered resting-state (RS) brain activity, as a measure of functional connectivity (FC), is commonly observed in chronic pain. Identifying a reliable signature pattern of altered RS activity for chronic pain could provide strong mechanistic insights and serve as a highly beneficial neuroimaging-based diagnostic tool. We collected and analyzed RS functional magnetic resonance imaging data from female patients with urologic chronic pelvic pain syndrome (N 45) and matched healthy participants (N 45) as part of an NIDDK-funded multicenter project (www.mappnetwork.org). Using dual regression and seed-based analyses, we observed significantly decreased FC of the default mode network to 2 regions in the posterior medial cortex (PMC): the posterior cingulate cortex (PCC) and the left precuneus (threshold-free cluster enhancement, family-wise error corrected P < 0.05). Further investigation revealed that patients demonstrated increased FC between the PCC and several brain regions implicated in pain, sensory, motor, and emotion regulation processes (eg, insular cortex, dorsolateral prefrontal cortex, thalamus, globus pallidus, putamen, amygdala, hippocampus). The left precuneus demonstrated decreased FC to several regions of pain processing, reward, and higher executive functioning within the prefrontal (orbitofrontal, anterior cingulate, ventromedial prefrontal) and parietal cortices (angular gyrus, superior and inferior parietal lobules). The altered PMC connectivity was associated with several phenotype measures, including pain and urologic symptom intensity, depression, anxiety, quality of relationships, and self-esteem levels in patients. Collectively, these findings indicate that in patients with urologic chronic pelvic pain syndrome, regions of the PMC are detached from the default mode network, whereas neurological processes of self-referential thought and introspection may be joined to pain and emotion regulatory processes.
AB - Altered resting-state (RS) brain activity, as a measure of functional connectivity (FC), is commonly observed in chronic pain. Identifying a reliable signature pattern of altered RS activity for chronic pain could provide strong mechanistic insights and serve as a highly beneficial neuroimaging-based diagnostic tool. We collected and analyzed RS functional magnetic resonance imaging data from female patients with urologic chronic pelvic pain syndrome (N 45) and matched healthy participants (N 45) as part of an NIDDK-funded multicenter project (www.mappnetwork.org). Using dual regression and seed-based analyses, we observed significantly decreased FC of the default mode network to 2 regions in the posterior medial cortex (PMC): the posterior cingulate cortex (PCC) and the left precuneus (threshold-free cluster enhancement, family-wise error corrected P < 0.05). Further investigation revealed that patients demonstrated increased FC between the PCC and several brain regions implicated in pain, sensory, motor, and emotion regulation processes (eg, insular cortex, dorsolateral prefrontal cortex, thalamus, globus pallidus, putamen, amygdala, hippocampus). The left precuneus demonstrated decreased FC to several regions of pain processing, reward, and higher executive functioning within the prefrontal (orbitofrontal, anterior cingulate, ventromedial prefrontal) and parietal cortices (angular gyrus, superior and inferior parietal lobules). The altered PMC connectivity was associated with several phenotype measures, including pain and urologic symptom intensity, depression, anxiety, quality of relationships, and self-esteem levels in patients. Collectively, these findings indicate that in patients with urologic chronic pelvic pain syndrome, regions of the PMC are detached from the default mode network, whereas neurological processes of self-referential thought and introspection may be joined to pain and emotion regulatory processes.
KW - Bladder pain syndrome
KW - DMN
KW - Default mode network
KW - Dual regression
KW - Interstitial cystitis
KW - Posterior cingulate cortex
KW - Precuneus
KW - Resting state
KW - UCPPS
KW - fMRI
UR - http://www.scopus.com/inward/record.url?scp=84952876061&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84952876061&partnerID=8YFLogxK
U2 - 10.1097/j.pain.0000000000000238
DO - 10.1097/j.pain.0000000000000238
M3 - Article
C2 - 26010458
AN - SCOPUS:84952876061
SN - 0304-3959
VL - 156
SP - 1755
EP - 1764
JO - Pain
JF - Pain
IS - 9
ER -