TY - JOUR
T1 - Brain perfusion patterns are altered in chronic knee pain
T2 - a spatial covariance analysis of arterial spin labelling MRI
AU - Iwabuchi, Sarina J.
AU - Xing, Yue
AU - Cottam, William J.
AU - Drabek, Marianne M.
AU - Tadjibaev, Arman
AU - Fernandes, Gwen S.
AU - Petersen, Kristian K
AU - Arendt-Nielsen, Lars
AU - Graven-Nielsen, Thomas
AU - Valdes, Ana M.
AU - Zhang, Weiya
AU - Doherty, Michael
AU - Walsh, David
AU - Auer, Dorothee P.
PY - 2020/6
Y1 - 2020/6
N2 - Chronic musculoskeletal pain is a common problem globally. Current evidence suggests that maladapted central pain pathways are associated with pain chronicity, for example, in postoperative pain after knee replacement. Other factors such as low mood, anxiety, and tendency to catastrophize are also important contributors. We aimed to investigate brain imaging features that underpin pain chronicity based on multivariate pattern analysis of cerebral blood flow (CBF), as a marker of maladaptive brain changes. This was achieved by identifying CBF patterns that discriminate chronic pain from pain-free conditions and by exploring their explanatory power for factors thought to drive pain chronification. In 44 chronic knee pain and 29 pain-free participants, we acquired both CBF and T1-weighted data. Participants completed questionnaires related to affective processes and pressure and cuff algometry to assess pain sensitization. Two factor scores were extracted from these scores representing negative affect and pain sensitization. A spatial covariance principal component analysis of CBF identified 5 components that significantly discriminated chronic pain participants from controls, with the unified network achieving 0.83 discriminatory accuracy (area under the curve). In chronic knee pain, significant patterns of relative hypoperfusion were evident in anterior default-mode and salience network hubs, while hyperperfusion was seen in posterior default mode, thalamus, and sensory regions. One component correlated positively with the pain sensitization score (r = 0.43, P = 0.006), suggesting that this CBF pattern reflects neural activity changes encoding pain sensitization. Here, we report a distinct chronic knee pain-related representation of CBF, pointing toward a brain signature underpinning central aspects of pain sensitization.
AB - Chronic musculoskeletal pain is a common problem globally. Current evidence suggests that maladapted central pain pathways are associated with pain chronicity, for example, in postoperative pain after knee replacement. Other factors such as low mood, anxiety, and tendency to catastrophize are also important contributors. We aimed to investigate brain imaging features that underpin pain chronicity based on multivariate pattern analysis of cerebral blood flow (CBF), as a marker of maladaptive brain changes. This was achieved by identifying CBF patterns that discriminate chronic pain from pain-free conditions and by exploring their explanatory power for factors thought to drive pain chronification. In 44 chronic knee pain and 29 pain-free participants, we acquired both CBF and T1-weighted data. Participants completed questionnaires related to affective processes and pressure and cuff algometry to assess pain sensitization. Two factor scores were extracted from these scores representing negative affect and pain sensitization. A spatial covariance principal component analysis of CBF identified 5 components that significantly discriminated chronic pain participants from controls, with the unified network achieving 0.83 discriminatory accuracy (area under the curve). In chronic knee pain, significant patterns of relative hypoperfusion were evident in anterior default-mode and salience network hubs, while hyperperfusion was seen in posterior default mode, thalamus, and sensory regions. One component correlated positively with the pain sensitization score (r = 0.43, P = 0.006), suggesting that this CBF pattern reflects neural activity changes encoding pain sensitization. Here, we report a distinct chronic knee pain-related representation of CBF, pointing toward a brain signature underpinning central aspects of pain sensitization.
KW - Chronic Pain
KW - ASL
KW - cerebral blood flow
KW - PCA
KW - Knee Osteoarthritis
KW - MRI
KW - experimental pain
KW - sensitisation
UR - http://www.scopus.com/inward/record.url?scp=85084917471&partnerID=8YFLogxK
U2 - 10.1097/j.pain.0000000000001829
DO - 10.1097/j.pain.0000000000001829
M3 - Journal article
SN - 0304-3959
VL - 161
SP - 1255
EP - 1263
JO - Pain
JF - Pain
IS - 6
ER -