HIV Distal Neuropathic Pain Is Associated with Smaller Ventral Posterior Cingulate Cortex
Abstract Objective. Despite modern antiretroviral therapy, HIV-associated neuropathy is one of the most prevalent, disabling and treatment-resistant complications of HIV disease. The presence and intensity of distal neuropathic pain is not fully explained by the degree of peripheral nerve damage. A...
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| Veröffentlicht in: | Pain medicine (Malden, Mass.) Mass.), 2017-03, Vol.18 (3), p.428-440 |
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| creator | Keltner, John R. Connolly, Colm G. Vaida, Florin Jenkinson, Mark Fennema-Notestine, Christine Archibald, Sarah Akkari, Cherine Schlein, Alexandra Lee, Jisu Wang, Dongzhe Kim, Sung Li, Han Rennels, Austin Miller, David J. Kesidis, George Franklin, Donald R. Sanders, Chelsea Corkran, Stephanie Grant, Igor Brown, Gregory G. Atkinson, J. Hampton Ellis, Ronald J. |
| description | Abstract
Objective. Despite modern antiretroviral therapy, HIV-associated neuropathy is one of the most prevalent, disabling and treatment-resistant complications of HIV disease. The presence and intensity of distal neuropathic pain is not fully explained by the degree of peripheral nerve damage. A better understanding of brain structure in HIV distal neuropathic pain may help explain why some patients with HIV neuropathy report pain while the majority does not. Previously, we reported that more intense distal neuropathic pain was associated with smaller total cerebral cortical gray matter volumes. The objective of this study was to determine which parts of the cortex are smaller.
Methods. HIV positive individuals with and without distal neuropathic pain enrolled in the multisite (N = 233) CNS HIV Antiretroviral Treatment Effects (CHARTER) study underwent structural brain magnetic resonance imaging. Voxel-based morphometry was used to investigate regional brain volumes in these structural brain images.
Results. Left ventral posterior cingulate cortex was smaller for HIV positive individuals with versus without distal neuropathic pain (peak P = 0.017; peak t = 5.15; MNI coordinates x = −6, y = −54, z = 20). Regional brain volumes within cortical gray matter structures typically associated with pain processing were also smaller for HIV positive individuals having higher intensity ratings of distal neuropathic pain.
Conclusions. The posterior cingulate is thought to be involved in inhibiting the perception of painful stimuli. Mechanistically a smaller posterior cingulate cortex structure may be related to reduced anti-nociception contributing to increased distal neuropathic pain. |
| doi_str_mv | 10.1093/pm/pnw180 |
| format | Article |
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Objective. Despite modern antiretroviral therapy, HIV-associated neuropathy is one of the most prevalent, disabling and treatment-resistant complications of HIV disease. The presence and intensity of distal neuropathic pain is not fully explained by the degree of peripheral nerve damage. A better understanding of brain structure in HIV distal neuropathic pain may help explain why some patients with HIV neuropathy report pain while the majority does not. Previously, we reported that more intense distal neuropathic pain was associated with smaller total cerebral cortical gray matter volumes. The objective of this study was to determine which parts of the cortex are smaller.
Methods. HIV positive individuals with and without distal neuropathic pain enrolled in the multisite (N = 233) CNS HIV Antiretroviral Treatment Effects (CHARTER) study underwent structural brain magnetic resonance imaging. Voxel-based morphometry was used to investigate regional brain volumes in these structural brain images.
Results. Left ventral posterior cingulate cortex was smaller for HIV positive individuals with versus without distal neuropathic pain (peak P = 0.017; peak t = 5.15; MNI coordinates x = −6, y = −54, z = 20). Regional brain volumes within cortical gray matter structures typically associated with pain processing were also smaller for HIV positive individuals having higher intensity ratings of distal neuropathic pain.
Conclusions. The posterior cingulate is thought to be involved in inhibiting the perception of painful stimuli. Mechanistically a smaller posterior cingulate cortex structure may be related to reduced anti-nociception contributing to increased distal neuropathic pain.</description><identifier>ISSN: 1526-2375</identifier><identifier>EISSN: 1526-4637</identifier><identifier>DOI: 10.1093/pm/pnw180</identifier><identifier>PMID: 27497320</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Aged ; Antiretroviral drugs ; Antiretroviral therapy ; Central nervous system ; Cortex (cingulate) ; Female ; Gray Matter ; Gyrus Cinguli - pathology ; HIV ; HIV Infections - complications ; Human immunodeficiency virus ; Humans ; Image Interpretation, Computer-Assisted ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Morphometry ; Neuralgia - pathology ; Neuralgia - virology ; Neuroimaging ; Pain ; Pain perception ; Peripheral neuropathy ; PSYCHOLOGY, PSYCHIATRY, IMAGING & BRAIN NEUROSCIENCE SECTION ; Substantia grisea ; Young Adult</subject><ispartof>Pain medicine (Malden, Mass.), 2017-03, Vol.18 (3), p.428-440</ispartof><rights>2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2016</rights><rights>2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com</rights><rights>Copyright © 2016 American Academy of Pain Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c432t-f62b657bf3a0ee2a27048091a657e807b85a5821fc1ec876a4d150c5d11eca333</citedby><cites>FETCH-LOGICAL-c432t-f62b657bf3a0ee2a27048091a657e807b85a5821fc1ec876a4d150c5d11eca333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27497320$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Keltner, John R.</creatorcontrib><creatorcontrib>Connolly, Colm G.</creatorcontrib><creatorcontrib>Vaida, Florin</creatorcontrib><creatorcontrib>Jenkinson, Mark</creatorcontrib><creatorcontrib>Fennema-Notestine, Christine</creatorcontrib><creatorcontrib>Archibald, Sarah</creatorcontrib><creatorcontrib>Akkari, Cherine</creatorcontrib><creatorcontrib>Schlein, Alexandra</creatorcontrib><creatorcontrib>Lee, Jisu</creatorcontrib><creatorcontrib>Wang, Dongzhe</creatorcontrib><creatorcontrib>Kim, Sung</creatorcontrib><creatorcontrib>Li, Han</creatorcontrib><creatorcontrib>Rennels, Austin</creatorcontrib><creatorcontrib>Miller, David J.</creatorcontrib><creatorcontrib>Kesidis, George</creatorcontrib><creatorcontrib>Franklin, Donald R.</creatorcontrib><creatorcontrib>Sanders, Chelsea</creatorcontrib><creatorcontrib>Corkran, Stephanie</creatorcontrib><creatorcontrib>Grant, Igor</creatorcontrib><creatorcontrib>Brown, Gregory G.</creatorcontrib><creatorcontrib>Atkinson, J. Hampton</creatorcontrib><creatorcontrib>Ellis, Ronald J.</creatorcontrib><creatorcontrib>CHARTER Group</creatorcontrib><title>HIV Distal Neuropathic Pain Is Associated with Smaller Ventral Posterior Cingulate Cortex</title><title>Pain medicine (Malden, Mass.)</title><addtitle>Pain Med</addtitle><description>Abstract
Objective. Despite modern antiretroviral therapy, HIV-associated neuropathy is one of the most prevalent, disabling and treatment-resistant complications of HIV disease. The presence and intensity of distal neuropathic pain is not fully explained by the degree of peripheral nerve damage. A better understanding of brain structure in HIV distal neuropathic pain may help explain why some patients with HIV neuropathy report pain while the majority does not. Previously, we reported that more intense distal neuropathic pain was associated with smaller total cerebral cortical gray matter volumes. The objective of this study was to determine which parts of the cortex are smaller.
Methods. HIV positive individuals with and without distal neuropathic pain enrolled in the multisite (N = 233) CNS HIV Antiretroviral Treatment Effects (CHARTER) study underwent structural brain magnetic resonance imaging. Voxel-based morphometry was used to investigate regional brain volumes in these structural brain images.
Results. Left ventral posterior cingulate cortex was smaller for HIV positive individuals with versus without distal neuropathic pain (peak P = 0.017; peak t = 5.15; MNI coordinates x = −6, y = −54, z = 20). Regional brain volumes within cortical gray matter structures typically associated with pain processing were also smaller for HIV positive individuals having higher intensity ratings of distal neuropathic pain.
Conclusions. The posterior cingulate is thought to be involved in inhibiting the perception of painful stimuli. Mechanistically a smaller posterior cingulate cortex structure may be related to reduced anti-nociception contributing to increased distal neuropathic pain.</description><subject>Adult</subject><subject>Aged</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Central nervous system</subject><subject>Cortex (cingulate)</subject><subject>Female</subject><subject>Gray Matter</subject><subject>Gyrus Cinguli - pathology</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Image Interpretation, Computer-Assisted</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morphometry</subject><subject>Neuralgia - pathology</subject><subject>Neuralgia - virology</subject><subject>Neuroimaging</subject><subject>Pain</subject><subject>Pain perception</subject><subject>Peripheral neuropathy</subject><subject>PSYCHOLOGY, PSYCHIATRY, IMAGING & BRAIN NEUROSCIENCE SECTION</subject><subject>Substantia grisea</subject><subject>Young Adult</subject><issn>1526-2375</issn><issn>1526-4637</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kUtPGzEUha2qqFBg0T9QWSqLskjxY_yYDRJKeURCBQmIxMpyHA8xmhkPtqeBf4-jCRF00ZWv7_3u0bk6AHzD6BdGJT3qmqOuXWKJPoEdzAgfFZyKz-uaUMG2wdcYHxHCvJD0C9gmoigFJWgH3F9MpvC3i0nX8I_tg-90WjgDr7Vr4STCkxi9cTrZOVy6tIA3ja5rG-DUtinknWsfkw3OBzh27UNfZxKOfUj2eQ9sVbqOdn_97oK7s9Pb8cXo8up8Mj65HJmCkjSqOJlxJmYV1chaoolAhUQl1rlpJRIzyTSTBFcGWyMF18UcM2TYHOe_ppTuguNBt-tnjZ2bwZjqgmt0eFFeO_Vx0rqFevB_FUeikMVK4OdaIPin3sakGheNrWvdWt9HhSVlnHBMWUZ__IM--j60-TyFS8lKwRBBmTocKBN8jMFWGzMYqVVgqmvUEFhmv793vyHfEsrAwQD4vvuPzisW5J41</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>Keltner, John R.</creator><creator>Connolly, Colm G.</creator><creator>Vaida, Florin</creator><creator>Jenkinson, Mark</creator><creator>Fennema-Notestine, Christine</creator><creator>Archibald, Sarah</creator><creator>Akkari, Cherine</creator><creator>Schlein, Alexandra</creator><creator>Lee, Jisu</creator><creator>Wang, Dongzhe</creator><creator>Kim, Sung</creator><creator>Li, Han</creator><creator>Rennels, Austin</creator><creator>Miller, David J.</creator><creator>Kesidis, George</creator><creator>Franklin, Donald R.</creator><creator>Sanders, Chelsea</creator><creator>Corkran, Stephanie</creator><creator>Grant, Igor</creator><creator>Brown, Gregory G.</creator><creator>Atkinson, J. Hampton</creator><creator>Ellis, Ronald J.</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170301</creationdate><title>HIV Distal Neuropathic Pain Is Associated with Smaller Ventral Posterior Cingulate Cortex</title><author>Keltner, John R. ; Connolly, Colm G. ; Vaida, Florin ; Jenkinson, Mark ; Fennema-Notestine, Christine ; Archibald, Sarah ; Akkari, Cherine ; Schlein, Alexandra ; Lee, Jisu ; Wang, Dongzhe ; Kim, Sung ; Li, Han ; Rennels, Austin ; Miller, David J. ; Kesidis, George ; Franklin, Donald R. ; Sanders, Chelsea ; Corkran, Stephanie ; Grant, Igor ; Brown, Gregory G. ; Atkinson, J. Hampton ; Ellis, Ronald J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c432t-f62b657bf3a0ee2a27048091a657e807b85a5821fc1ec876a4d150c5d11eca333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral therapy</topic><topic>Central nervous system</topic><topic>Cortex (cingulate)</topic><topic>Female</topic><topic>Gray Matter</topic><topic>Gyrus Cinguli - pathology</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Image Interpretation, Computer-Assisted</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morphometry</topic><topic>Neuralgia - pathology</topic><topic>Neuralgia - virology</topic><topic>Neuroimaging</topic><topic>Pain</topic><topic>Pain perception</topic><topic>Peripheral neuropathy</topic><topic>PSYCHOLOGY, PSYCHIATRY, IMAGING & BRAIN NEUROSCIENCE SECTION</topic><topic>Substantia grisea</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Keltner, John R.</creatorcontrib><creatorcontrib>Connolly, Colm G.</creatorcontrib><creatorcontrib>Vaida, Florin</creatorcontrib><creatorcontrib>Jenkinson, Mark</creatorcontrib><creatorcontrib>Fennema-Notestine, Christine</creatorcontrib><creatorcontrib>Archibald, Sarah</creatorcontrib><creatorcontrib>Akkari, Cherine</creatorcontrib><creatorcontrib>Schlein, Alexandra</creatorcontrib><creatorcontrib>Lee, Jisu</creatorcontrib><creatorcontrib>Wang, Dongzhe</creatorcontrib><creatorcontrib>Kim, Sung</creatorcontrib><creatorcontrib>Li, Han</creatorcontrib><creatorcontrib>Rennels, Austin</creatorcontrib><creatorcontrib>Miller, David J.</creatorcontrib><creatorcontrib>Kesidis, George</creatorcontrib><creatorcontrib>Franklin, Donald R.</creatorcontrib><creatorcontrib>Sanders, Chelsea</creatorcontrib><creatorcontrib>Corkran, Stephanie</creatorcontrib><creatorcontrib>Grant, Igor</creatorcontrib><creatorcontrib>Brown, Gregory G.</creatorcontrib><creatorcontrib>Atkinson, J. Hampton</creatorcontrib><creatorcontrib>Ellis, Ronald J.</creatorcontrib><creatorcontrib>CHARTER Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pain medicine (Malden, Mass.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Keltner, John R.</au><au>Connolly, Colm G.</au><au>Vaida, Florin</au><au>Jenkinson, Mark</au><au>Fennema-Notestine, Christine</au><au>Archibald, Sarah</au><au>Akkari, Cherine</au><au>Schlein, Alexandra</au><au>Lee, Jisu</au><au>Wang, Dongzhe</au><au>Kim, Sung</au><au>Li, Han</au><au>Rennels, Austin</au><au>Miller, David J.</au><au>Kesidis, George</au><au>Franklin, Donald R.</au><au>Sanders, Chelsea</au><au>Corkran, Stephanie</au><au>Grant, Igor</au><au>Brown, Gregory G.</au><au>Atkinson, J. Hampton</au><au>Ellis, Ronald J.</au><aucorp>CHARTER Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>HIV Distal Neuropathic Pain Is Associated with Smaller Ventral Posterior Cingulate Cortex</atitle><jtitle>Pain medicine (Malden, Mass.)</jtitle><addtitle>Pain Med</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>18</volume><issue>3</issue><spage>428</spage><epage>440</epage><pages>428-440</pages><issn>1526-2375</issn><eissn>1526-4637</eissn><abstract>Abstract
Objective. Despite modern antiretroviral therapy, HIV-associated neuropathy is one of the most prevalent, disabling and treatment-resistant complications of HIV disease. The presence and intensity of distal neuropathic pain is not fully explained by the degree of peripheral nerve damage. A better understanding of brain structure in HIV distal neuropathic pain may help explain why some patients with HIV neuropathy report pain while the majority does not. Previously, we reported that more intense distal neuropathic pain was associated with smaller total cerebral cortical gray matter volumes. The objective of this study was to determine which parts of the cortex are smaller.
Methods. HIV positive individuals with and without distal neuropathic pain enrolled in the multisite (N = 233) CNS HIV Antiretroviral Treatment Effects (CHARTER) study underwent structural brain magnetic resonance imaging. Voxel-based morphometry was used to investigate regional brain volumes in these structural brain images.
Results. Left ventral posterior cingulate cortex was smaller for HIV positive individuals with versus without distal neuropathic pain (peak P = 0.017; peak t = 5.15; MNI coordinates x = −6, y = −54, z = 20). Regional brain volumes within cortical gray matter structures typically associated with pain processing were also smaller for HIV positive individuals having higher intensity ratings of distal neuropathic pain.
Conclusions. The posterior cingulate is thought to be involved in inhibiting the perception of painful stimuli. Mechanistically a smaller posterior cingulate cortex structure may be related to reduced anti-nociception contributing to increased distal neuropathic pain.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>27497320</pmid><doi>10.1093/pm/pnw180</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Pain medicine (Malden, Mass.), 2017-03, Vol.18 (3), p.428-440 |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Adult Aged Antiretroviral drugs Antiretroviral therapy Central nervous system Cortex (cingulate) Female Gray Matter Gyrus Cinguli - pathology HIV HIV Infections - complications Human immunodeficiency virus Humans Image Interpretation, Computer-Assisted Magnetic Resonance Imaging Male Middle Aged Morphometry Neuralgia - pathology Neuralgia - virology Neuroimaging Pain Pain perception Peripheral neuropathy PSYCHOLOGY, PSYCHIATRY, IMAGING & BRAIN NEUROSCIENCE SECTION Substantia grisea Young Adult |
| title | HIV Distal Neuropathic Pain Is Associated with Smaller Ventral Posterior Cingulate Cortex |
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