(348) Alteration of Brain Connectivity and Response in Women with Provoked Vestibulodynia

• Published in: The journal of pain Vol. 20; no. 4; p. S61
• Main Authors: Yessick, L., Stroman, P., Chamberlain, S., Pukall, C.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2019
• ISSN: 1526-5900; 1528-8447
• DOI: 10.1016/j.jpain.2019.02.044

Provoked Vestibulodynia (PVD) is the most common subtype of vulvodynia. Functional MRI studies have indicated that women with PVD exhibit increased BOLD responses in pain modulation regions2-4. However, few neuroimaging studies have examined either the periods of time before and after a noxious stimulus is applied, nor compared fMRI responses between participants experiencing a noxious stimulus versus no stimulus5. The present study filled this gap in knowledge and was the first to apply network connectivity analysis to identify the coordination across brain regions involved with pain processing in PVD. A total of 28 women with PVD and healthy women first underwent quantitative sensory testing to determine the temperature that evoked a moderate pain rating in response to the thermal stimulus to be used for subsequent fMRI studies. This was followed by an MRI session which consisted of 5 fMRI runs with no stimulus, interleaved randomly with 5 runs with stimulation. The stimulation paradigm included 2-minute-long “baseline” periods before and after stimulation.  The results showed consistent significant connectivity between brain regions which was relatively similar between the groups, although there were significant differences in connectivity strengths. Despite the similarities in connected regions, the groups differed at what point of the study paradigm they exhibited significant BOLD response variations and the direction of differences varied by region. Despite similarities in regions of connectivity between groups, this study adds to a body of research that confirms alterations in the fMRI response of brain regions both before and during a noxious stimulus in PVD. Supported by the National Vulvodynia Association. 1Hampson, Reed, Clauw, Bhavsar, Gracely, Haefner, & Harris, Journal of Pain, 2013; 2Pukall, Strigo, Binik, Amsel, Khalifé, & Bushnell, Pain, 2005; 3Pazmany, Ly, Aerts, Kano, Bergeron, Verhaeghe, ... & VanOudenhove, NeuroImage, 2017; 4Stroman, Ioachim, Powers, Staud, & Pukall, Pain, 2018