Distinctive alterations in the functional anatomy of the cerebral cortex in pain-sensitized osteoarthritis and fibromyalgia patients
Pujol Nuez, Jesús (Centro de Investigación Biomédica en Red de Salud Mental)
Blanco Hinojo, Laura (Centro de Investigación Biomédica en Red de Salud Mental)
Doreste, Andrea (Hospital del Mar (Barcelona, Catalunya))
Ojeda, Fabiola (Hospital del Mar (Barcelona, Catalunya))
Martínez-Vilavella, Gerard (Hospital del Mar (Barcelona, Catalunya))
Pérez Solà, Víctor (Institut Hospital del Mar d'Investigacions Mèdiques)
Deus Yela, Juan (Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut)
Monfort, Jordi (Hospital del Mar (Barcelona, Catalunya))

Fecha:	2022
Resumen:	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. 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. 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. 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. The online version contains supplementary material available at 10. 1186/s13075-022-02942-3.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Functional MRI ; Pain sensitization ; Fibromyalgia ; Knee osteoarthritis ; Somatosensory cortex ; Insular cortex
Publicado en:	Arthritis research & therapy, Vol. 24 (november 2022) , ISSN 1478-6362

DOI: 10.1186/s13075-022-02942-3
PMID: 36369217

13 p, 1.7 MB

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