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Gray matter alterations and pain-related emotional processing in patients with adenomyosis-associated dysmenorrhea: a neuroimaging perspective

Yunfan Wu,Zichao Chen,Man Liang,Jiejing Li,Wenqing Xiao,Yanying Chen,Rujin Li,Kanghui Yu,Wenjiang Wei

Published 2023 in Quantitative Imaging in Medicine and Surgery

ABSTRACT

Background Adenomyosis is a prevalent gynecological condition among women of reproductive age and is commonly associated with heavy menstrual bleeding, severe dysmenorrhea, and infertility. These symptoms impose a substantial burden on both physical health and psychological well-being. Despite increasing recognition of its clinical impact, it remains unclear whether dysmenorrhea in adenomyosis is accompanied by structural brain alterations. Therefore, the present study aims to investigate whether adenomyosis-related dysmenorrhea is associated with changes in brain structure. Understanding such alterations may provide novel insights into the neural mechanisms underlying chronic pain and emotional disturbances in affected patients. Methods Fifty-one patients with adenomyosis-associated dysmenorrhea (AAD) and 51 demographically matched healthy controls (HCs) were recruited. Voxel-based morphometry was used to identify differences in gray matter volume (GMV). Between-group differences were analyzed using two-sample t-tests, and partial correlation analyses were conducted to assess the relationships between altered GMV and clinical symptoms within the AAD group. Results Compared with HCs, patients with AAD exhibited significant GMV changes in the right fusiform gyrus, right parahippocampal gyrus, right lingual gyrus, left superior frontal gyrus, and bilateral thalamus. Notably, decreased GMV in the right fusiform and right parahippocampal gyri was significantly correlated with pain and emotional scale scores. Conclusions The observed gray matter abnormalities may underlie the neural mechanisms of pain and emotional disturbances in patients with AAD. These findings enhance our understanding of the brain’s role in the interaction between chronic pain and emotional symptoms in AAD.

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