Effect of uterine artery embolization therapy on ReHo values in brain regions related to pain perception and emotion regulation in adenomyosis patients accompanied by dysmenorrhea.

This study investigates changes in regional homogeneity (ReHo) of the brain in patients with adenomyosis accompanied by dysmenorrhea (AMD) before and after uterine artery embolization (UAE) surgery. ReHo is a resting-state functional magnetic resonance imaging (fMRI)-based analysis for assessing the temporal synchronization of local neuronal activity in the brain. This study involved 32 patients with AMD who underwent UAE surgery. Resting-state functional magnetic resonance imaging (fMRI) scans were performed before and after the procedure. A paired t-test analyzed ReHo images to identify significant changes across various brain regions. Each participant underwent relevant laboratory tests and was evaluated using pain and emotional scales. Correlation analyses were subsequently conducted to examine relationships between these clinical features and pre-treatment ReHo values in the identified brain regions. This study found that compared with pre-treatment, ReHo values decreased in the left hippocampus, left caudate nucleus, and left putamen, while increasing in the right paracentral lobule and right cuneus. Particularly, pre-treatment ReHo values in the left hippocampus were positively correlated with scores on the Visual Analog Scale (VAS), Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD), suggesting that the left hippocampus plays an important role in the processing of pain and adverse emotions in AMD. These findings provide evidence for reversible central plasticity following pain relief in AMD, offering new insights into the neurobiological mechanisms of AMD, and may assist in developing more effective treatment strategies. PERSPECTIVE: This study identified significant changes in ReHo in several brain regions of AMD patients before and after treatment with UAE, especially the hippocampus was associated with preoperative pain level and related emotions, demonstrating that reversible central plasticity can occur after dysmenorrhea relief, which may help clinicians to formulate therapeutic strategies.