Altered resting state MR functional connectivity in women with chronic pelvic pain

Marti-Bonmati, Luis
2020 · doi:10.26044/ecr2020/c-07636 · W6908624905
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High-resolution resting-state functional MRI in women with chronic pelvic pain revealed that physiotherapy significantly increased Default Mode Network connectivity, while Salience Network connectivity remained unchanged.

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This study utilized high-resolution resting-state functional magnetic resonance imaging to assess changes in the Default Mode Network and Salience Network connectivity among fifteen women with chronic pelvic pain before and after physiotherapy. The researchers found a significant increase in Default Mode Network connectivity following the intervention, whereas no significant differences were observed in the Salience Network. The authors note that while neuropsychological therapies are associated with altered Default Mode Network connectivity, further studies incorporating diffusion tensor imaging are needed to clarify structural connections. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Keywords

Neuro, CNS, MR, Computer Applications-General, Pelvic floor dysfunction, Prospective, Not applicable, Performed at one institution Authors: G. Garcia-Marti1, L. Marti-Bonmati2, R. Sanz-Requena2, R. torres2; 1Valencia, València/ES, 2Valencia/ES DOI: 10.26044/ecr2020/C-07636 Purpose Resting state functional magnetic resonance imaging (rs-fMRI) has revealed altered connectivity patterns in patients with chronic pelvic pain. Disruptions of the Default Mode Network (DMN) and Salience Network (SN) have been associated to clinical and functional effects in this disease [1]. The aim of this study is to use high-resolution rs-fMRI sequences to study the DMN and SN functional connectivity in a homogeneous sample of patients with chronic pelvic pain and to evaluate the effect of physiotherapy in these patients.

Methods

and materials Fifteen patients with chronic pelvic pain (all women) with a mean age of 37.8 ± 10.1 years, were recruited for this study. All subjects were MR evaluated twice (before and after physiotherapy) on a 3T magnet (Philips Achieva, Best, the Netherlands). The following rs-fMRI BOLD sequence was acquired: echo-planar imaging, 180 dynamics, TR=2200 ms, TE=30 ms, FA=90º, 38 contiguous slices with no interslice gap, voxel size 2.88 x 2.88 x 3.60 mm, NEX=1. Images were improved with non-local postprocessing methods for minimizing signal inhomogeneity and...

Results

Using and independent component analysis approach, the DMN and SN were extracted for all subjects. A significant increase of DMN functional connectivity was observed in chronic pelvic pain patients after physiotherapy, compared with the baseline MR (ANOVA. p=0.046; F=4.222). No differences of functional connectivity were observed in the SN (ANOVA. p=0.415; F=0.678) (Fig. 1).

Conclusion

There are significant alterations of the DMN connectivity associated to neuropsychological therapies in this homogeneous sample of patients with chronic pelvic pain. However, no disruptions of the SN were found. Further studies with additional clinical information and MR techniques such as diffusion tensor imaging to evaluate structural connectivity, will help to clarify the effect of the DMN and SN in chronic pelvic pain. Personal information and conflict of interest L. Marti-Bonmati; Valencia/ES - nothing to disclose G. Garcia-Marti; Valencia, VALÈNCIA/ES - nothing to disclose R. Sanz-Requena; Valencia/ES - nothing to disclose R. Torres; Valencia/ES - nothing to disclose

References

1.Martucci KT1, Shirer WR, Bagarinao E, Johnson KA, Farmer MA, Labus JS, Apkarian AV, Deutsch G, Harris RE, Mayer EA, Clauw DJ, Greicius MD, Mackey SC. The posterior medial cortex in urologic chronic pelvic pain syndrome: detachment from default mode network-a resting-state study from the MAPP Research Network. Pain. 2015. 156(9):1755-64.

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chronic_pelvic_pain

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