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PLoS One. 2019 Jun 20;14(6):e0217610. doi: 10.1371/journal.pone.0217610. eCollection 2019.

Impact of early adverse life events and sex on functional brain networks in patients with urological chronic pelvic pain syndrome (UCPPS): A MAPP Research Network study.

Author information

1
G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, United States of America.
2
David Geffen School of Medicine, UCLA, Los Angeles, CA, United States of America.
3
Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, United States of America.
4
USC Division of Biokinesiology and Physical Therapy, Los Angeles, CA, United States of America.
5
Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, United States of America.
6
Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States of America.
7
Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States of America.
8
Department of Urology, University of Iowa, Iowa City, IA, United States of America.
9
Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, United States of America.
10
Ahmanson-Lovelace Brain Mapping Center, UCLA, Los Angeles, CA, United States of America.

Abstract

Pain is a highly complex and individualized experience with biopsychosocial components. Neuroimaging research has shown evidence of the involvement of the central nervous system in the development and maintenance of chronic pain conditions, including urological chronic pelvic pain syndrome (UCPPS). Furthermore, a history of early adverse life events (EALs) has been shown to adversely impact symptoms throughout childhood and into adulthood. However, to date, the role of EAL's in the central processes of chronic pain have not been adequately investigated. We studied 85 patients (56 females) with UCPPS along with 86 healthy controls (HCs) who had resting-state magnetic resonance imaging scans (59 females), and data on EALs as a part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network Study. We used graph theory methods in order to investigate the impact of EALs on measures of centrality, which characterize information flow, communication, influence, and integration in a priori selected regions of interest. Patients with UCPPS exhibited lower centrality in the right anterior insula compared to HCs, a key node in the salience network. Males with UCPPS exhibited lower centrality in the right anterior insula compared the HC males. Females with UCPPS exhibited greater centrality in the right caudate nucleus and left angular gyrus compared to HC females. Males with UCPPS exhibited lower centrality in the left posterior cingulate, angular gyrus, middle temporal gyrus, and superior temporal sulcus, but greater centrality in the precuneus and anterior mid-cingulate cortex (aMCC) compared to females with UCPPS. Higher reports of EALs was associated with greater centrality in the left precuneus and left aMCC in females with UCPPS. This study provides evidence for disease and sex-related alterations in the default mode, salience, and basal ganglia networks in patients with UCPPS, which are moderated by EALs, and associated with clinical symptoms and quality of life (QoL).

Conflict of interest statement

The authors have declared that no competing interests exist.

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