Altered Associations between Pain Symptoms and Brain Morphometry in the Pain Matrix of HIV-Seropositive Individuals
Pain remains highly prevalent in HIV-seropositive (HIV+) patients despite their well-suppressed viremia with combined antiretroviral therapy. Investigating brain abnormalities within the pain matrix, and in relation to pain symptoms, in HIV+ participants may provide objective biomarkers and insights...
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Published in | Journal of neuroimmune pharmacology Vol. 13; no. 1; pp. 77 - 89 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
New York
Springer US
01.03.2018
Springer Nature B.V |
Subjects | |
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Abstract | Pain remains highly prevalent in HIV-seropositive (HIV+) patients despite their well-suppressed viremia with combined antiretroviral therapy. Investigating brain abnormalities within the pain matrix, and in relation to pain symptoms, in HIV+ participants may provide objective biomarkers and insights regarding their pain symptoms. We used Patient-Reported Outcome Measurement Information System (PROMIS®) pain questionnaire to evaluate pain symptoms (pain intensity, pain interference and pain behavior), and structural MRI to assess brain morphometry using FreeSurfer (cortical area, cortical thickness and subcortical volumes were evaluated in 12 regions within the pain matrix). Compared to seronegative (SN) controls, HIV+ participants had smaller surface areas in prefrontal pars triangularis (right:
p
= 0.04, left:
p
= 0.007) and right anterior cingulate cortex (
p
= 0.03) and smaller subcortical regions (thalamus:
p
≤ 0.003 bilaterally; right putamen:
p
= 0.01), as well as higher pain scores (pain intensity-
p
= 0.005; pain interference-
p
= 0.008; pain-behavior-
p
= 0.04). Furthermore, higher pain scores were associated with larger cortical areas, thinner cortices and larger subcortical volumes in HIV+ participants; but smaller cortical areas, thicker cortices and smaller subcortical volumes in SN controls (interaction-
p
= 0.009 to
p
= 0.04). These group differences in the pain-associated brain abnormalities suggest that HIV+ individuals have abnormal pain responses. Since these abnormal pain-associated brain regions belong to the affective component of the pain matrix, affective symptoms may influence pain perception in HIV+ patients and should be treated along with their physical pain symptoms. Lastly, associations of lower pain scores with better physical or mental health scores, regardless of HIV-serostatus (
p
< 0.001), suggest adequate pain treatment would lead to better quality of life in all participants. |
---|---|
AbstractList | Pain remains highly prevalent in HIV-seropositive (HIV+) patients despite their well-suppressed viremia with combined antiretroviral therapy. Investigating brain abnormalities within the pain matrix, and in relation to pain symptoms, in HIV+ participants may provide objective biomarkers and insights regarding their pain symptoms. We used Patient-Reported Outcome Measurement Information System (PROMIS®) pain questionnaire to evaluate pain symptoms (pain intensity, pain interference and pain behavior), and structural MRI to assess brain morphometry using FreeSurfer (cortical area, cortical thickness and subcortical volumes were evaluated in 12 regions within the pain matrix). Compared to seronegative (SN) controls, HIV+ participants had smaller surface areas in prefrontal pars triangularis (right: p = 0.04, left: p = 0.007) and right anterior cingulate cortex (p = 0.03) and smaller subcortical regions (thalamus: p ≤ 0.003 bilaterally; right putamen: p = 0.01), as well as higher pain scores (pain intensity-p = 0.005; pain interference-p = 0.008; pain-behavior-p = 0.04). Furthermore, higher pain scores were associated with larger cortical areas, thinner cortices and larger subcortical volumes in HIV+ participants; but smaller cortical areas, thicker cortices and smaller subcortical volumes in SN controls (interaction-p = 0.009 to p = 0.04). These group differences in the pain-associated brain abnormalities suggest that HIV+ individuals have abnormal pain responses. Since these abnormal pain-associated brain regions belong to the affective component of the pain matrix, affective symptoms may influence pain perception in HIV+ patients and should be treated along with their physical pain symptoms. Lastly, associations of lower pain scores with better physical or mental health scores, regardless of HIV-serostatus (p < 0.001), suggest adequate pain treatment would lead to better quality of life in all participants. Pain remains highly prevalent in HIV-seropositive (HIV+) patients despite their well-suppressed viremia with combined antiretroviral therapy. Investigating brain abnormalities within the pain matrix, and in relation to pain symptoms, in HIV+ participants may provide objective biomarkers and insights regarding their pain symptoms. We used Patient-Reported Outcome Measurement Information System (PROMIS®) pain questionnaire to evaluate pain symptoms (pain intensity, pain interference and pain behavior), and structural MRI to assess brain morphometry using FreeSurfer (cortical area, cortical thickness and subcortical volumes were evaluated in 12 regions within the pain matrix). Compared to seronegative (SN) controls, HIV+ participants had smaller surface areas in prefrontal pars triangularis (right: p = 0.04, left: p = 0.007) and right anterior cingulate cortex (p = 0.03) and smaller subcortical regions (thalamus: p ≤ 0.003 bilaterally; right putamen: p = 0.01), as well as higher pain scores (pain intensity-p = 0.005; pain interference-p = 0.008; pain-behavior-p = 0.04). Furthermore, higher pain scores were associated with larger cortical areas, thinner cortices and larger subcortical volumes in HIV+ participants; but smaller cortical areas, thicker cortices and smaller subcortical volumes in SN controls (interaction-p = 0.009 to p = 0.04). These group differences in the pain-associated brain abnormalities suggest that HIV+ individuals have abnormal pain responses. Since these abnormal pain-associated brain regions belong to the affective component of the pain matrix, affective symptoms may influence pain perception in HIV+ patients and should be treated along with their physical pain symptoms. Lastly, associations of lower pain scores with better physical or mental health scores, regardless of HIV-serostatus (p < 0.001), suggest adequate pain treatment would lead to better quality of life in all participants. Pain remains highly prevalent in HIV-seropositive (HIV+) patients despite their well-suppressed viremia with combined antiretroviral therapy. Investigating brain abnormalities within the pain matrix, and in relation to pain symptoms, in HIV+ participants may provide objective biomarkers and insights regarding their pain symptoms. We used Patient-Reported Outcome Measurement Information System (PROMIS®) pain questionnaire to evaluate pain symptoms (pain intensity, pain interference and pain behavior), and structural MRI to assess brain morphometry using FreeSurfer (cortical area, cortical thickness and subcortical volumes were evaluated in 12 regions within the pain matrix). Compared to seronegative (SN) controls, HIV+ participants had smaller surface areas in prefrontal pars triangularis (right: p = 0.04, left: p = 0.007) and right anterior cingulate cortex ( p = 0.03) and smaller subcortical regions (thalamus: p ≤ 0.003 bilaterally; right putamen: p = 0.01), as well as higher pain scores (pain intensity- p = 0.005; pain interference- p = 0.008; pain-behavior- p = 0.04). Furthermore, higher pain scores were associated with larger cortical areas, thinner cortices and larger subcortical volumes in HIV+ participants; but smaller cortical areas, thicker cortices and smaller subcortical volumes in SN controls (interaction- p = 0.009 to p = 0.04). These group differences in the pain-associated brain abnormalities suggest that HIV+ individuals have abnormal pain responses. Since these abnormal pain-associated brain regions belong to the affective component of the pain matrix, affective symptoms may influence pain perception in HIV+ patients and should be treated along with their physical pain symptoms. Lastly, associations of lower pain scores with better physical or mental health scores, regardless of HIV-serostatus ( p < 0.001), suggest adequate pain treatment would lead to better quality of life in all participants. Pain remains highly prevalent in HIV-seropositive (HIV+) patients despite their well-suppressed viremia with combined antiretroviral therapy. Investigating brain abnormalities within the pain matrix, and in relation to pain symptoms, in HIV+ participants may provide objective biomarkers and insights regarding their pain symptoms. We used Patient-Reported Outcome Measurement Information System (PROMIS ® ) pain questionnaire to evaluate pain symptoms (pain intensity, pain interference and pain behavior), and structural MRI to assess brain morphometry using FreeSurfer (cortical area, cortical thickness and subcortical volumes were evaluated in 12 regions within the pain matrix). Compared to seronegative (SN) controls, HIV+ participants had smaller surface areas in prefrontal pars triangularis (right: p=0.04, left: p=0.007) and right anterior cingulate cortex (p=0.03) and smaller subcortical regions (thalamus: p<0.003 bilaterally; right putamen: p=0.01), as well as higher pain scores (pain intensity-p=0.005; pain interference-p=0.008; p-behavior-p=0.04). Furthermore, higher pain scores were associated with larger cortical areas, thinner cortices and larger subcortical volumes in HIV+ participants; but smaller cortical areas, thicker cortices and smaller subcortical volumes in SN controls (interaction-p=0.009 to p=0.04). These group differences in the pain-associated brain abnormalities suggest that HIV+ individuals have abnormal pain responses. Since these abnormal pain-associated brain regions belong to the affective component of the pain matrix, affective symptoms may influence pain perception in HIV+ patients and should be treated along with their physical pain symptoms. Lastly, associations of lower pain scores with better physical or mental health scores, regardless of HIV-serostatus (p<0.001), suggest adequate pain treatment would lead to better quality of life in all participants. Pain remains highly prevalent in HIV-seropositive (HIV+) patients despite their well-suppressed viremia with combined antiretroviral therapy. Investigating brain abnormalities within the pain matrix, and in relation to pain symptoms, in HIV+ participants may provide objective biomarkers and insights regarding their pain symptoms. We used Patient-Reported Outcome Measurement Information System (PROMIS®) pain questionnaire to evaluate pain symptoms (pain intensity, pain interference and pain behavior), and structural MRI to assess brain morphometry using FreeSurfer (cortical area, cortical thickness and subcortical volumes were evaluated in 12 regions within the pain matrix). Compared to seronegative (SN) controls, HIV+ participants had smaller surface areas in prefrontal pars triangularis (right: p = 0.04, left: p = 0.007) and right anterior cingulate cortex (p = 0.03) and smaller subcortical regions (thalamus: p ≤ 0.003 bilaterally; right putamen: p = 0.01), as well as higher pain scores (pain intensity-p = 0.005; pain interference-p = 0.008; pain-behavior-p = 0.04). Furthermore, higher pain scores were associated with larger cortical areas, thinner cortices and larger subcortical volumes in HIV+ participants; but smaller cortical areas, thicker cortices and smaller subcortical volumes in SN controls (interaction-p = 0.009 to p = 0.04). These group differences in the pain-associated brain abnormalities suggest that HIV+ individuals have abnormal pain responses. Since these abnormal pain-associated brain regions belong to the affective component of the pain matrix, affective symptoms may influence pain perception in HIV+ patients and should be treated along with their physical pain symptoms. Lastly, associations of lower pain scores with better physical or mental health scores, regardless of HIV-serostatus (p < 0.001), suggest adequate pain treatment would lead to better quality of life in all participants. |
Author | Castillo, Deborrah Ernst, Thomas Cunningham, Eric Chang, Linda |
AuthorAffiliation | 2 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 419 W. Redwood Street, Suite 225, Baltimore, MD 21201, USA 1 John A. Burns School of Medicine, University of Hawaii at Manoa, Neuroscience and MR Research Program, 1356 Lusitana Street, 7th Floor, Honolulu, HI 96813, USA |
AuthorAffiliation_xml | – name: 2 Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 419 W. Redwood Street, Suite 225, Baltimore, MD 21201, USA – name: 1 John A. Burns School of Medicine, University of Hawaii at Manoa, Neuroscience and MR Research Program, 1356 Lusitana Street, 7th Floor, Honolulu, HI 96813, USA |
Author_xml | – sequence: 1 givenname: Deborrah surname: Castillo fullname: Castillo, Deborrah organization: John A. Burns School of Medicine, Neuroscience and MR Research Program, University of Hawaii at Manoa – sequence: 2 givenname: Thomas surname: Ernst fullname: Ernst, Thomas organization: John A. Burns School of Medicine, Neuroscience and MR Research Program, University of Hawaii at Manoa, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine – sequence: 3 givenname: Eric surname: Cunningham fullname: Cunningham, Eric organization: John A. Burns School of Medicine, Neuroscience and MR Research Program, University of Hawaii at Manoa, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine – sequence: 4 givenname: Linda orcidid: 0000-0002-1267-0699 surname: Chang fullname: Chang, Linda email: lchang@hawaii.edu, linda.chang@umm.edu organization: John A. Burns School of Medicine, Neuroscience and MR Research Program, University of Hawaii at Manoa, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28866752$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_3389_fpain_2022_1004060 crossref_primary_10_3390_jcm9082436 crossref_primary_10_3389_fnins_2020_601063 crossref_primary_10_1038_s41380_023_02294_7 crossref_primary_10_1002_hbm_24577 crossref_primary_10_3389_fnagi_2018_00056 crossref_primary_10_1093_cercor_bhab210 crossref_primary_10_1097_01_TPM_0000544666_41582_7a |
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Copyright | Springer Science+Business Media, LLC 2017 Journal of Neuroimmune Pharmacology is a copyright of Springer, (2017). All Rights Reserved. |
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Keywords | Affective pain Global health Brain morphometry Neuroinflammation HIV |
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SubjectTerms | Biomedical and Life Sciences Biomedicine Cell Biology Immunology Neurosciences Original Article Pain Pharmacology/Toxicology Virology |
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Title | Altered Associations between Pain Symptoms and Brain Morphometry in the Pain Matrix of HIV-Seropositive Individuals |
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