title: HIV Distal Neuropathic Pain Is Associated with Smaller Ventral Posterior Cingulate Cortex.
abstract: . 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.
  
  
  
  . 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.
  
  
  
  . 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.
  
  
  
  . 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.
authors: Department of Psychiatry, University of California San Diego, San Diego, CA, USA.|VA San Diego Healthcare System, San Diego, California, USA.
authors: John R
authors: JR
authors: Keltner
authors: Department of Psychiatry, University of California, San Francisco, San Francisco, California, USA.
authors: Colm G
authors: CG
authors: Connolly
authors: Department of Family and Preventative Medicine, University of California San Diego Medical Center, San Diego, California, USA.
authors: Florin
authors: F
authors: Vaida
authors: Department of Clinical Neurosciences, University of Oxford, Oxford, England.
authors: Mark
authors: M
authors: Jenkinson
authors: Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
authors: Christine
authors: C
authors: Fennema-Notestine
authors: Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
authors: Sarah
authors: S
authors: Archibald
authors: Psychiatry, University of California San Diego, California, USA.
authors: Cherine
authors: C
authors: Akkari
authors: Psychiatry, University of California San Diego, California, USA.
authors: Alexandra
authors: A
authors: Schlein
authors: Psychiatry, University of California San Diego, California, USA.
authors: Jisu
authors: J
authors: Lee
authors: Department of Electrical Engineering, Pennsylvania State University, State College, Pennsylvania, USA.
authors: Dongzhe
authors: D
authors: Wang
authors: Psychiatry, University of California San Diego, California, USA.
authors: Sung
authors: S
authors: Kim
authors: Psychiatry, University of California San Diego, California, USA.
authors: Han
authors: H
authors: Li
authors: Psychiatry, University of California San Diego, California, USA.
authors: Austin
authors: A
authors: Rennels
authors: Department of Electrical Engineering, Pennsylvania State University, State College, Pennsylvania, USA.
authors: David J
authors: DJ
authors: Miller
authors: Department of Electrical Engineering, Pennsylvania State University, State College, Pennsylvania, USA.
authors: George
authors: G
authors: Kesidis
authors: Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
authors: Donald R
authors: DR
authors: Franklin
authors: Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
authors: Chelsea
authors: C
authors: Sanders
authors: Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
authors: Stephanie
authors: S
authors: Corkran
authors: Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
authors: Igor
authors: I
authors: Grant
authors: Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
authors: Gregory G
authors: GG
authors: Brown
authors: Department of Psychiatry, University of California San Diego, San Diego, CA, USA.|VA San Diego Healthcare System, San Diego, California, USA.
authors: J Hampton
authors: JH
authors: Atkinson
authors: Neurosciences, University of California San Diego, San Diego, California, USA.
authors: Ronald J
authors: RJ
authors: Ellis
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D066128:Gray Matter; D006179:Gyrus Cinguli / Q000473:pathology*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000473:pathology* / Q000821:virology*; D055815:Young Adult
keywords: HIV Distal Neuropathic Pain; Posterior Cingulate Cortex; Structural Magnetic Resonance Imaging; Voxel-Based Morphometry