Liu Ni, Li Yingqiu, Hong Yueying, Huo Jianwei, Chang Tai, Wang Haoyuan, Huang Yiran, Li Wenxun, Zhang Yanan
Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.
Front Neurosci. 2023 Jan 30;17:1098573. doi: 10.3389/fnins.2023.1098573. eCollection 2023.
Patients with primary dysmenorrhea (PDM) often present with abnormalities other than dysmenorrhea including co-occurrence with other chronic pain conditions and central sensitization. Changes in brain activity in PDM have been demonstrated; however, the results are not consistent. Herein, this study probed into altered intraregional and interregional brain activity in patients with PDM and expounded more findings.
A total of 33 patients with PDM and 36 healthy controls (HCs) were recruited and underwent a resting-state functional magnetic resonance imaging scan. Regional homogeneity (ReHo) and mean amplitude of low-frequency fluctuation (mALFF) analysis were applied to compare the difference in intraregional brain activity between the two groups, and the regions with ReHo and mALFF group differences were used as seeds for functional connectivity (FC) analysis to explore the difference of interregional activity. Pearson's correlation analysis was conducted between rs-fMRI data and clinical symptoms in patients with PDM.
Compared with HCs, patients with PDM showed altered intraregional activity in a series of brain regions, including the hippocampus, the temporal pole superior temporal gyrus, the nucleus accumbens, the pregenual anterior cingulate cortex, the cerebellum_8, the middle temporal gyrus, the inferior temporal gyrus, the rolandic operculum, the postcentral gyrus and the middle frontal gyrus (MFG), and altered interregional FC mainly between regions of the mesocorticolimbic pathway and regions associated with sensation and movement. The anxiety symptoms are correlated with the intraregional activity of the right temporal pole superior temporal gyrus and FC between MFG and superior frontal gyrus.
Our study showed a more comprehensive method to explore changes in brain activity in PDM. We found that the mesocorticolimbic pathway might play a key role in the chronic transformation of pain in PDM. We, therefore, speculate that the modulation of the mesocorticolimbic pathway may be a potential novel therapeutic mechanism for PDM.
原发性痛经（PDM）患者常伴有痛经以外的异常情况，包括与其他慢性疼痛疾病共病以及中枢敏化。已有研究证实PDM患者脑活动存在变化；然而，结果并不一致。在此，本研究探讨了PDM患者脑内区域内和区域间活动的改变，并阐述了更多发现。
共招募了33例PDM患者和36名健康对照者（HCs），并对其进行静息态功能磁共振成像扫描。应用局部一致性（ReHo）和低频振幅均值（mALFF）分析比较两组脑内区域活动的差异，并将ReHo和mALFF组间差异区域作为种子点进行功能连接（FC）分析，以探索区域间活动的差异。对PDM患者的静息态功能磁共振成像数据与临床症状进行Pearson相关性分析。
与HCs相比，PDM患者在一系列脑区的区域内活动发生改变，包括海马体、颞极上颞回、伏隔核、膝前扣带回皮质、小脑8区、颞中回、颞下回、中央前回、中央后回和额中回（MFG），区域间FC改变主要发生在中皮质边缘通路区域与感觉和运动相关区域之间。焦虑症状与右侧颞极上颞回的区域内活动以及MFG与额上回之间的FC相关。
我们的研究展示了一种更全面的方法来探索PDM患者脑活动的变化。我们发现中皮质边缘通路可能在PDM疼痛的慢性转变中起关键作用。因此，我们推测调节中皮质边缘通路可能是PDM一种潜在的新型治疗机制。
