Altered activity of pain processing brain regions in association with hip osteoarthritis

P Railton,G R Sutherland,S Lama,B G Goodyear,J N Powell,A J Delaney,J Matyas

doi:10.1038/s41598-022-06499-8

P Railton, G R Sutherland + Show 5 more

Open Access

https://doi.org/10.1038/s41598-022-06499-8

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Journal: Scientific Reports	Publication Date: Feb 18, 2022
Citations: 6	License type: open-access

Affiliation: Charles Sturt University, University of Calgary

Abstract

Hip osteoarthritis (OA) is characterized by chronic pain, but there remains a mismatch between symptoms and radiological findings. Recently, brain connectivity has been implicated in the modulation of chronic peripheral pain, however its association with perceived pain in hip OA is not understood. We used resting-state functional magnetic resonance imaging (fMRI) to examine functional connectivity associated with pain in hip OA patients. Thirty participants with hip OA and 10 non-OA controls were recruited. Using the visual analogue scale (VAS), pain scores were obtained before and after performing a painful hip activity. All participants underwent 3.0 T resting-state fMRI, and functional connectivity of brain regions associated with pain was determined and compared between participants, and before and after hip activity. Relative to controls, functional connectivity between the secondary somatosensory cortex and left posterior insula was increased, and functional connectivity between the bilateral posterior insula and motor cortices was significantly decreased in hip OA participants. In response to painful hip activity, functional connectivity increased between the thalamus, periaqueductal grey matter and brainstem. Functional connections between brain regions associated with pain are altered in hip OA patients, and several connections are modulated by performing painful activity. Unique lateralization of left posterior insula and linked brain functional connectivity patterns allows assessment of pain perception in hip OA providing an unbiased method to evaluate pain perception and pain modulation strategies.

Highlights

Hip osteoarthritis (OA) is characterized by chronic pain, but there remains a mismatch between symptoms and radiological findings
Functional magnetic resonance imaging has demonstrated changes within brain circuits involved in the perception of pain[18].These studies using functional magnetic resonance imaging (fMRI) report increased activity within the thalamus, posterior and anterior insula, secondary somatosensory cortex, anterior cingulate cortex and periacqueductal grey matter
A resting-state fMRI study of knee OA patients following arthroplasty demonstrated changes in the temporal synchrony between the rostal anterior cingulate cortex and rostral ventromedial m edulla[23]

Summary

Introduction

Hip osteoarthritis (OA) is characterized by chronic pain, but there remains a mismatch between symptoms and radiological findings. The lack of association between radiological indicators of hip osteoarthritis (OA) and self-reported pain by individual patients[1,2,3,4] emphasizes the long recognized, but poorly understood mismatch between symptoms and radiological signs of OA This places limits on how we effectively treat the perceived pain associated with chronic hip OA. Functional magnetic resonance imaging (fMRI) has demonstrated changes within brain circuits involved in the perception of pain[18].These studies using fMRI report increased activity within the thalamus, posterior and anterior insula, secondary somatosensory cortex, anterior cingulate cortex and periacqueductal grey matter. Wager called this a pain signature within the brain[19]. A volumetric brain MRI study of hip OA patients demonstrated evidence of reversal of thalamic atrophy following total joint a rthroplasty[24], suggesting that CNS changes may be reversible following the removal of the (peripheral) stimulus of chronic joint pain

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