Chronic pain in adults with sickle cell disease is associated with alterations in functional connectivity of the brain

• Published in: PloS one 2019-05, Vol.14 (5), p.e0216994-e0216994
• Main Authors: Karafin, Matthew S, Chen, Guangyu, Wandersee, Nancy J, Brandow, Amanda M, Hurley, Robert W, Simpson, Pippa, Ward, Doug, Li, Shi-Jiang, Field, Joshua J
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adults; African Americans; Anemia, Sickle Cell - complications; Anemia, Sickle Cell - diagnostic imaging; Anemia, Sickle Cell - physiopathology; Biology and Life Sciences; Biophysics; Brain; Brain - diagnostic imaging; Brain - physiopathology; Brain Mapping; Chronic pain; Chronic Pain - complications; Chronic Pain - diagnostic imaging; Chronic Pain - physiopathology; Comparative analysis; Complications and side effects; Development and progression; Female; Fibromyalgia; Functional magnetic resonance imaging; Health aspects; Hematology; Hospitals; Humans; Magnetic Resonance Imaging; Male; Medical records; Medicine and Health Sciences; Middle Aged; Nerve Net; Neural networks; Neural Pathways - physiopathology; Neuroplasticity; Observational studies; Pain; Pathogenesis; Patients; Periaqueductal Gray - diagnostic imaging; Periaqueductal Gray - physiopathology; Physiological aspects; Plasticity; Research and Analysis Methods; Rest - physiology; Risk factors; Sickle cell anemia; Sickle cell disease; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0216994

Chronic pain affects 50% of adults with sickle cell disease (SCD). Although central sensitization is thought to contribute to the pathogenesis of this chronic pain, no studies have examined differences in functional connectivity of the brain between patients with SCD with and without chronic pain. We performed an observational cohort study using resting-state functional MRI (rsfMRI) of the brain on adults with SCD with and without chronic pain. We tested the hypothesis that, compared to those without chronic pain, those with chronic pain would have differences in functional connectivity between the periaqueductal grey (PAG) and other regions of the brain. Twenty-two adults with SCD, 15 with chronic pain and 7 without chronic pain, as well as 10 African-American controls, underwent rsfMRI of the brain. When SCD patients with chronic pain were compared to those without chronic pain, significant differences in connectivity were noted between the PAG and 9 regions of the brain, including several in the default mode network, a network involved in introspection that has been implicated in other chronic pain syndromes. Changes in functional connectivity between patients with SCD with and without chronic pain suggest a mechanism for chronic pain that involves neuro-plastic changes to the brain.