Abstract
Primary dysmenorrhea (PDM) is the most commonly encountered gynecological problem in reproductive-age women. Acupuncture has been suggested as an effective treatment of PDM that may modulate descending pain modulation systems. In the present study, we used resting-state functional magnetic resonance imaging to investigate possible changes in descending pain modulation systems after acupuncture treatment in women with PDM. Thirty-four right-handed adult women with PDM participated in this randomized, single-blinded, sham-controlled study. Each patient was randomly allocated to an 8-week verum or sham acupuncture intervention on the bilateral Sanyinjiao (SP6). Resting-state functional magnetic resonance imaging was conducted before, during, and after the intervention to measure the spontaneous activity in brain. After the 8-week intervention, both verum and sham groups reported decreased menstrual pain. However, the cessation of decreased functional connectivity (FC) between periaqueductal gray matter and the regions associated with affective pain modulation and attention-related pain modulation were found in the verum but not in the sham group after the 8-week intervention. More decreased FC has been found in the region associated with non-specific effects of acupuncture intervention after the early stage of acupuncture intervention. These results indicated that verum acupuncture may intercept the altered FC in descending pain modulation systems in PDM.
Highlights
Licensee MDPI, Basel, Switzerland.Primary dysmenorrhea (PDM) is the most common gynecological problem among reproductive-age women
Several abnormal functional and structural changes have been reported in brain regions associated with visceral sensation and pain processing [5,6], as well as how altered functional connectivity (FC) between ventral periaqueductal gray matter (PAG) and other pain-related brain regions in women with PDM indicate the maladaptation of the descending pain modulation system [7]
More decreased FC was found in the sham group than in the verum group in the regions associated with affective pain modulation and attention-related pain modulation after 8 weeks of intervention, whereas more decreased FC was found in the verum group than in the sham group in the region associated with non-specific effects of acupuncture intervention after the early stage of acupuncture intervention
Summary
Licensee MDPI, Basel, Switzerland.Primary dysmenorrhea (PDM) is the most common gynecological problem among reproductive-age women. Women with PDM experience cramping pain during menses, which may be due to an abnormal concentration of prostanoids, uterine hypercontractility, or reduced uterine blood flow [2]. They have a lower pain threshold in referred pain sites and the non-referred with regard to jurisdictional claims in published maps and institutional affil-. Several abnormal functional and structural changes have been reported in brain regions associated with visceral sensation and pain processing [5,6], as well as how altered functional connectivity (FC) between ventral periaqueductal gray matter (PAG) and other pain-related brain regions in women with PDM indicate the maladaptation of the descending pain modulation system [7]
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