Psychotherapy With Somatosensory Stimulation for Endometriosis-Associated Pain: The Role of the Anterior Hippocampus

Florian Beissner, Florian Beißner, Preibisch C, Christine Preibisch, Annemarie Schweizer-Arau, Schweizer-Arau A, Popovici RM, Roxana M Popovici, Roxana Popovici, Karin Meissner, Karin Meißner
Biological psychiatry · 2017 · vol. 84(10) , pp. 734–742 · doi:10.1016/j.biopsych.2017.01.006 · PMID:28258747 · W2574754760
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This study investigated how psychotherapy combined with somatosensory stimulation affects endometriosis-associated pain by examining the role of the anterior hippocampus.

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Abstract

BackgroundEndometriosis is a gynecological disorder affecting 6%-10% of all women in their reproductive age. There is an emerging view in the literature that psychological trauma plays a central role in the pathogenesis of pelvic pain, one of the core symptoms of endometriosis. Here we report central nervous system mechanisms of a novel combination of psychotherapy and somatosensory stimulation that has recently shown remarkable effects in reducing pain, anxiety, and depressive symptoms in these patients.MethodsWe conducted a randomized controlled trial; 67 patients with severe endometriosis-associated pain (maximum pain: 7.6 ± 2.0, average pain: 4.5 ± 2.0 on a 10-point numeric rating scale) were included in the study and randomly allocated to intervention (35 patients) or waitlist control (32 patients) groups. Resting-state functional magnetic resonance imaging was used to assess brain connectivity of these patients at baseline, after 3 months of therapy, and after 6 months. The analysis focused on the hippocampus.ResultsWe identified a cortical network comprising the right anterolateral hippocampus-a region modulating the hypothalamic-pituitary-adrenal axis-and somatosensory, viscerosensory, and interoceptive brain regions. Regression analysis showed that reduction in connectivity predicted therapy-induced improvement in patients׳ anxiety.ConclusionsWe have identified a putative neurobiological mechanism underlying the potent combination of psychotherapy and somatic stimulation in treating symptoms of endometriosis.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Hippocampus Pain Management Pelvic Pain Psychotherapy Adult Analysis of Variance Endometriosis Female Hippocampus Humans Magnetic Resonance Imaging Pain Management Pain Measurement Pelvic Pain Physical Stimulation Regression Analysis

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