Pain Distribution Associated with Brain Pathology
In patients with centralized pain, brain pathology is related to pain distribution throughout the body, according to the results of a recent study.
In their study, researchers analyzed data from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network study, which included a total of 1079 participants who were diagnosed with urological chronic pelvic pain syndrome (UCPPS) or with fibromyalgia or who were pain free. Questionnaires on pain severity, function, and a body map of pain were completed by all participants. In addition, 110 participants with UCPPS, 23 participants with fibromyalgia, and 49 participants without pain underwent functional and structural magnetic resonance imaging.
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_______________________________________________________________________________________________________________________________Notably, many participants with UCPPS not only reported pelvic pain, but also widely distributed pain. Those who reported widespread pain had increased brain gray matter volume and functional connectivity involving the sensorimotor and insular cortices, which were identical to magnetic resonance imaging scans of participants with fibromyalgia. Additionally, widespread pain was found to be associated with reduced physical and mental function independent of pain severity.
“Brain pathology in patients with centralized pain is related to pain distribution throughout the body,” the researchers concluded.
“We think that this type of study will help treat these patients because if they have a central nerve biological component to their disorder, they’re much more likely to benefit from targets that affect the central nervous system rather than from treatments that are aimed at the pelvic region.”2
—Melissa Weiss
Reference:
1) Kutch JJ, Ichesco E, Hampson JP, et al. Brain signature and functional impact of centralized pain: a multidisciplinary approach to the study of chronic pelvic pain (MAPP) network study [published online June 30, 2017]. Pain. doi: 10.1097/j.pain.0000000000001001.
2) Does widespread pain stem from the brain? MRI study investigates [press release]. Ann Arbor, MI: M Health Lab; August 7, 2017. http://labblog.uofmhealth.org/lab-report/does-widespread-pain-stem-from-brain-mri-study-investigates.