Functional resonance magnetic imaging (fMRI) in adolescents with idiopathic musculoskeletal pain: a paradigm of experimental pain

Functional resonance magnetic imaging (fMRI) in adolescents with idiopathic musculoskeletal pain: a paradigm of experimental pain

Author Molina, Juliana Autor UNIFESP Google Scholar
Amaro, Edson, Jr. Google Scholar
Sanches da Rocha, Liana Guerra Google Scholar
Jorge, Liliana Google Scholar
Santos, Flavia Heloisa Google Scholar
Len, Claudio A. Autor UNIFESP Google Scholar
Abstract Background: Studies on functional magnetic resonance imaging (fMRI) have shown that adults with musculoskeletal pain syndromes tolerate smaller amount of pressure (pain) as well as differences in brain activation patterns in areas related to pain. The objective of this study was to evaluate, through fMRI, the brain activation in adolescents with idiopathic musculoskeletal pain (IMP) while performing an experimental paradigm of pain. Methods: The study included 10 consecutive adolescents with idiopathic musculoskeletal pain (average age 16.3 +/- 1.0) and 10 healthy adolescents age-matched. fMRI exams were performed in a 3 T scanner (Magnetom Trio, Siemens) using an event-related design paradigm. Pressure stimuli were performed in the nondominant hand thumb, divided into two stages, fixed pain and variable pain. The two local Research Ethics Committees (Ethics Committee from Universidade Federal de Sao Paulo- Brazil, process number 0688/11, on July 1st, 2011 and Ethics Committee from Hospital Israelita Albert Einsten - Brazil, process number 1673, on October 19th, 2011) approved the study. Results: The idiopathic musculoskeletal pain (IMP) group showed a reduced threshold for pain (3.7 kg/cm(2) versus 4. 45 kg/cm2, p = 0.005). Control group presented increased bain activation when compared to IMP group in the following areas: thalamus (p = 0.00001), precentral gyrus (p = 0.0004) and middle frontal gyrus (p = 0.03). In intragroup analysis, IMP group showed greater brain activation during the unpredictable stimuli of the variable pain stage, especially in the lingual gyrus (p = 0.0001), frontal lobe (p = 0.0001), temporal gyrus (p = 0.0001) and precentral gyrus (p = 0.03), when compared to predictable stimulus of fixed pain. The same intragroup analysis with the control group showed greater activation during the unpredictable stimuli in regions of the precentral gyrus (p = 0.0001), subcallosal area (p = 0.0001), right and left occipital fusiform gyrus (p = 0.0001; (p = 0.0007), middle gyrus (p = 0.01) and precuneus p = (0.02). Conclusion: Adolescents with idiopathic musculoskeletal pain (IMP) tend to request higher brain function in cognitive-emotional areas when interpreting unpredictable sensory-perceptual situations. Therefore, it is assumed that this difference in pain processing in adolescents with IMP make the subjective experience of pain something more intense and unpleasant.
Keywords Musculoskeletal pain
Magnetic resonance imaging
Functional neuroimaging
Juvenile fibromyalgia
xmlui.dri2xhtml.METS-1.0.item-coverage London
Language English
Sponsor Hospital Israelita Albert Einstein
CAPES (Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior)
Date 2017
Published in Pediatric Rheumatology. London, v. 15, p. -, 2017.
ISSN 1546-0096 (Sherpa/Romeo, impact factor)
Publisher Biomed Central Ltd
Extent -
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000415122500001

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