Brain morphofunctional changes associated with pain in children, adolescents and young adults with sickle cell disease

Abstract

INTRODUCTION: Neuroimaging has been widely used to investigate the brain signature in patients with pain, but the results are heterogeneous, especially when the brain is under development, and in specific health conditions. Sickle cell disease (SCD) is often associated with chronic pain that starts in infancy, and there is a need to understand the brain of such children. OBJECTIVES: This systematic review aims to summarize the findings in the literature on brain morphofunctional changes in children, adolescents, young adults, and young adults with SCD. METHODS: Data search was performed in PubMed, LILACS, and SciELO, and results were organized to identify brain regions that showed significant structural and functional changes assessed through structural or functional MRI, or electroencephalography. RESULTS: The synthesis of five studies showed that children with SCD present decreased cerebral cortex thickness, and increased functional connectivity, mainly concentrated in the precuneus and anterior cingulate cortex, regions that make up the default mode network (DMN), and/or the pro-nociceptive network. DISCUSSION: These alterations were related to the frequency of pain and hospitalizations, and the increased connectivity in structures of the antinociceptive network is associated with a decrease in the frequency of pain crises and their consequences. CONCLUSION: Children, adolescents and young adults with SCD have decreased thickness and connectivity in the anterior cingulate cortex and precuneus.