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- Title
Primary somatosensory cortex and periaqueductal gray functional connectivity as a marker of the dysfunction of the descending pain modulatory system in fibromyalgia.
- Authors
Soldatelli, Matheus; de Oliveira Franco, Álvaro; Picon, Felipe; Ávila Duarte, Juliana; Scherer, Ricardo; Bandeira, Janete; Zortea, Maxciel; da Silva Torres, Iraci Lucena; Fregni, Felipe; Caumo, Wolnei
- Abstract
Background: Resting-state functional connectivity (rs-FC) may aid in understanding the link between painmodulating brain regions and the descending pain modulatory system (DPMS) in fibromyalgia (FM). This study investigated whether the differences in rs-FC of the primary somatosensory cortex in responders and non-responders to the conditioned pain modulation test (CPM-test) are related to pain, sleep quality, central sensitization, and the impact of FM on quality of life. Methods: This cross-sectional study included 33 females with FM. rs-FC was assessed by functional magnetic resonance imaging. Change in the numerical pain scale during the CPM-test assessed the DPMS function. Subjects were classified either as non-responders (i.e., DPMS dysfunction, n = 13) or responders (n = 20) to CPM-test. A generalized linear model (GLM) and a receiver operating characteristic (ROC) curve analysis were performed to check the accuracy of the rs-FC to differentiate each group. Results: Non-responders showed a decreased rs-FC between the left somatosensory cortex (S1) and the periaqueductal gray (PAG) (P < 0.001). The GLM analysis revealed that the S1-PAG rs-FC in the left-brain hemisphere was positively correlated with a central sensitization symptom and negatively correlated with sleep quality and pain scores. ROC curve analysis showed that left S1-PAG rs-FC offers a sensitivity and specificity of 85% or higher (area under the curve, 0.78, 95% confidence interval, 0.63–0.94) to discriminate who does/does not respond to the CPM-test. Conclusions: These results support using the rs-FC patterns in the left S1-PAG as a marker for predicting CPM-test response, which may aid in treatment individualization in FM patients.
- Subjects
SOMATOSENSORY cortex; FIBROMYALGIA; FUNCTIONAL connectivity; FUNCTIONAL magnetic resonance imaging; SLEEP quality; RECEIVER operating characteristic curves
- Publication
Korean Journal of Pain, 2023, Vol 36, Issue 1, p113
- ISSN
2005-9159
- Publication type
Article
- DOI
10.3344/kjp.22225