Distinctive alterations in the functional anatomy of the cerebral cortex in pain-sensitized osteoarthritis and fibromyalgia patients
Abstract Background Pain-sensitized osteoarthritis and fibromyalgia patients characteristically show nociceptive system augmented responsiveness as a common feature. However, sensitization can be originally related to the peripheral injury in osteoarthritis patients, whereas pain and bodily discomfo...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | Arthritis Research & Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13075-022-02942-3 |
| _version_ | 1817970581982674944 |
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| author | Jesus Pujol Laura Blanco-Hinojo Andrea Doreste Fabiola Ojeda Gerard Martínez-Vilavella Víctor Pérez-Sola Joan Deus Jordi Monfort |
| author_facet | Jesus Pujol Laura Blanco-Hinojo Andrea Doreste Fabiola Ojeda Gerard Martínez-Vilavella Víctor Pérez-Sola Joan Deus Jordi Monfort |
| author_sort | Jesus Pujol |
| collection | DOAJ |
| description | Abstract Background Pain-sensitized osteoarthritis and fibromyalgia patients characteristically show nociceptive system augmented responsiveness as a common feature. However, sensitization can be originally related to the peripheral injury in osteoarthritis patients, whereas pain and bodily discomfort spontaneously occur in fibromyalgia with no apparent origin. We investigated the distinct functional repercussion of pain sensitization in the cerebral cortex in both conditions. Methods Thirty-one pain-sensitized knee osteoarthritis patients and 38 fibromyalgia patients were compared with matched control groups. And new samples of 34 sensitized knee osteoarthritis and 63 fibromyalgia patients were used to directly compare each condition. A combined measure of local functional connectivity was estimated to map functional alterations in the cerebral cortex at rest. Results In osteoarthritis, weaker local connectivity was identified in the insula, which is a cortical area processing important aspects of the brain response to painful stimulation. In contrast, fibromyalgia patients showed weaker connectivity in the sensorimotor cortex extensively affecting the cortical representation of the body. Conclusions In osteoarthritis, weaker insular cortex connectivity is compatible with reduced neural activity during metabolic recovery after repeated activation. In the fibromyalgia neurophysiological context, weaker connectivity may better express both reduced neural activity and increased excitability, particularly affecting the sensorimotor cortex in patients with spontaneous body pain. Such a combination is compatible with a central gain enhancement mechanism, where low sensory tolerance results from the over-amplification of central sensory reception to compensate a presumably weak sensory input. We propose that deficient proprioception could be a factor contributing to weak sensory input. |
| first_indexed | 2024-04-13T20:36:54Z |
| format | Article |
| id | doaj.art-4f10018014d64ca481c6440b5763ad77 |
| institution | Directory Open Access Journal |
| issn | 1478-6362 |
| language | English |
| last_indexed | 2024-04-13T20:36:54Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthritis Research & Therapy |
| spelling | doaj.art-4f10018014d64ca481c6440b5763ad772022-12-22T02:31:01ZengBMCArthritis Research & Therapy1478-63622022-11-0124111310.1186/s13075-022-02942-3Distinctive alterations in the functional anatomy of the cerebral cortex in pain-sensitized osteoarthritis and fibromyalgia patientsJesus Pujol0Laura Blanco-Hinojo1Andrea Doreste2Fabiola Ojeda3Gerard Martínez-Vilavella4Víctor Pérez-Sola5Joan Deus6Jordi Monfort7MRI Research Unit, Department of Radiology, Hospital del MarMRI Research Unit, Department of Radiology, Hospital del MarMRI Research Unit, Department of Radiology, Hospital del MarRheumatology Department, Hospital del MarMRI Research Unit, Department of Radiology, Hospital del MarCIBER de Salud Mental, Instituto de Salud Carlos IIIMRI Research Unit, Department of Radiology, Hospital del MarRheumatology Department, Hospital del MarAbstract Background Pain-sensitized osteoarthritis and fibromyalgia patients characteristically show nociceptive system augmented responsiveness as a common feature. However, sensitization can be originally related to the peripheral injury in osteoarthritis patients, whereas pain and bodily discomfort spontaneously occur in fibromyalgia with no apparent origin. We investigated the distinct functional repercussion of pain sensitization in the cerebral cortex in both conditions. Methods Thirty-one pain-sensitized knee osteoarthritis patients and 38 fibromyalgia patients were compared with matched control groups. And new samples of 34 sensitized knee osteoarthritis and 63 fibromyalgia patients were used to directly compare each condition. A combined measure of local functional connectivity was estimated to map functional alterations in the cerebral cortex at rest. Results In osteoarthritis, weaker local connectivity was identified in the insula, which is a cortical area processing important aspects of the brain response to painful stimulation. In contrast, fibromyalgia patients showed weaker connectivity in the sensorimotor cortex extensively affecting the cortical representation of the body. Conclusions In osteoarthritis, weaker insular cortex connectivity is compatible with reduced neural activity during metabolic recovery after repeated activation. In the fibromyalgia neurophysiological context, weaker connectivity may better express both reduced neural activity and increased excitability, particularly affecting the sensorimotor cortex in patients with spontaneous body pain. Such a combination is compatible with a central gain enhancement mechanism, where low sensory tolerance results from the over-amplification of central sensory reception to compensate a presumably weak sensory input. We propose that deficient proprioception could be a factor contributing to weak sensory input.https://doi.org/10.1186/s13075-022-02942-3Functional MRIPain sensitizationFibromyalgiaKnee osteoarthritisSomatosensory cortexInsular cortex |
| spellingShingle | Jesus Pujol Laura Blanco-Hinojo Andrea Doreste Fabiola Ojeda Gerard Martínez-Vilavella Víctor Pérez-Sola Joan Deus Jordi Monfort Distinctive alterations in the functional anatomy of the cerebral cortex in pain-sensitized osteoarthritis and fibromyalgia patients Arthritis Research & Therapy Functional MRI Pain sensitization Fibromyalgia Knee osteoarthritis Somatosensory cortex Insular cortex |
| title | Distinctive alterations in the functional anatomy of the cerebral cortex in pain-sensitized osteoarthritis and fibromyalgia patients |
| title_full | Distinctive alterations in the functional anatomy of the cerebral cortex in pain-sensitized osteoarthritis and fibromyalgia patients |
| title_fullStr | Distinctive alterations in the functional anatomy of the cerebral cortex in pain-sensitized osteoarthritis and fibromyalgia patients |
| title_full_unstemmed | Distinctive alterations in the functional anatomy of the cerebral cortex in pain-sensitized osteoarthritis and fibromyalgia patients |
| title_short | Distinctive alterations in the functional anatomy of the cerebral cortex in pain-sensitized osteoarthritis and fibromyalgia patients |
| title_sort | distinctive alterations in the functional anatomy of the cerebral cortex in pain sensitized osteoarthritis and fibromyalgia patients |
| topic | Functional MRI Pain sensitization Fibromyalgia Knee osteoarthritis Somatosensory cortex Insular cortex |
| url | https://doi.org/10.1186/s13075-022-02942-3 |
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