Altered connectivity of the right anterior insula drives the pain connectome changes in chronic knee osteoarthritis
Resting-state functional connectivity (FC) has proven a powerful approach to understand the neural underpinnings of chronic pain, reporting altered connectivity in 3 main networks: the default mode network (DMN), central executive network, and the salience network (SN). The interrelation and possible mechanisms of these changes are less well understood in chronic pain. Based on emerging evidence of its role to drive switches between network states, the right anterior insula (rAI, an SN hub) may play a dominant role in network connectivity changes underpinning chronic pain. To test this hypothesis, we used seed-based resting-state FC analysis including dynamic and effective connectivity metrics in 25 people with chronic osteoarthritis (OA) pain and 19 matched healthy volunteers. Compared with controls, participants with painful knee OA presented with increased anticorrelation between the rAI (SN) and DMN regions. Also, the left dorsal prefrontal cortex (central executive network hub) showed more negative FC with the right temporal gyrus. Granger causality analysis revealed increased negative influence of the rAI on the posterior cingulate (DMN) in patients with OA in line with the observed enhanced anticorrelation. Moreover, dynamic FC was lower in the DMN of patients and thus more similar to temporal dynamics of the SN. Together, these findings evidence a widespread network disruption in patients with persistent OA pain and point toward a driving role of the rAI.
Conditions: Knee Osteoarthritis; Pain, Chronic Intervention: Procedure: Acupuncture Sponsor: University of Sao Paulo General Hospital Active, not recruiting
Authors: Konya ZY, Akin Takmaz S, Başar H, Baltaci B, Babaoğlu G Abstract BACKGROUND/AIM: The aim of this study was to investigate the medium- to long-term effects of radiofrequency (RF) ablation of genicular nerves for chronic refractory knee pain due to osteoarthritis (OA). MATERIALS AND METHODS: Forty-eight patients who underwent RF ablation of the genicular nerves were evaluated retrospectively. The visual analogue scale (VAS) score, Western Ontario and McMaster Universities Arthritis Index (WOMAC index), opioid and nonsteroidal anti-inflammatory drug (NSAID) use score, quality of life score, and treatmen...
Pain catastrophizing has been shown to predict greater pain and less physical function in daily life for chronic pain sufferers, but its effects on close social partners have received much less attention. The overall purpose of this study was to examine the extent to which pain catastrophizing is an interpersonal coping strategy that is maladaptive for patients and their spouses. A total of 144 older knee osteoarthritis patients and their spouses completed baseline interviews and a 22-day diary assessment. Multilevel lagged models indicated that, on days when patients reported greater catastrophizing in the morning, their ...
Publication date: Available online 16 November 2019Source: Orthopaedics &Traumatology: Surgery &ResearchAuthor(s): Christophe Mathoulin, Mathilde GrasAbstractScapholunate ligament tear is most frequently encountered in the aftermath of trauma in supination and extension of the wrist. It generates chronic instability, leading to osteoarthritis. It may be associated with fracture of the distal epiphysis of the radius or of the scaphoid. These lesions are often difficult to diagnose, especially in early stages. Treatment of chronic scapholunate ligament lesions before onset of osteoarthritis is a challenge for the sur...
Conditions: Pain Syndrome; Pain, Chronic; Knee Osteoarthritis Intervention: Other: Pressure pain threshold and behavioural data Sponsor: Acibadem University Not yet recruiting
Knee osteoarthritis (KOA) is a chronic pain condition that is one of the leading causes of physical impairment and disability across the world.40 The prevalence of KOA is expected to continuously escalate due to population aging and increases in obesity rates.63 Women are particularly at-risk for developing chronic pain and KOA.20,43 Further, women generally report higher pain-related symptoms (including KOA symptoms57), evoked-pain sensitivity, and lower pain tolerance compared to men.20,43
Conditions: Osteoarthritis, Knee; Knee Pain Chronic Interventions: Behavioral: Gait Retraining; Behavioral: Control Sponsor: Northeastern University Not yet recruiting