title: Associations of limbic-affective brain activity and severity of ongoing chronic arthritis pain are explained by trait anxiety.
abstract: Functional magnetic resonance imaging studies (fMRI) have transformed our understanding of central processing of evoked pain but the typically used block and event-related designs are not best suited to the study of ongoing pain. Here we used arterial spin labelling (ASL) for cerebral blood flow mapping to characterise the neural correlates of perceived intensity of osteoarthritis (OA) pain and its interrelation with negative affect. Twenty-six patients with painful knee OA and twenty-seven healthy controls underwent pain phenotyping and ASL MRI at 3T. Intensity of OA pain correlated positively with blood flow in the anterior mid-cingulate cortex (aMCC), subgenual cingulate cortex (sgACC), bilateral hippocampi, bilateral amygdala, left central operculum, mid-insula, putamen and the brainstem. Additional control for trait anxiety scores reduced the pain-CBF association to the aMCC, whilst pain catastrophizing scores only explained some of the limbic correlations. In conclusion, we found that neural correlates of reported intensity of ongoing chronic pain intensity mapped to limbic-affective circuits, and that the association pattern apart from aMCC was explained by trait anxiety thus highlighting the importance of aversiveness in the experience of clinical pain.
authors: Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, UK; Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK; Division of Clinical Neuroscience, Radiological Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
authors: William J
authors: WJ
authors: Cottam
authors: Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, UK; Division of Clinical Neuroscience, Radiological Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
authors: Laura
authors: L
authors: Condon
authors: Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, UK; Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK; Division of Clinical Neuroscience, Radiological Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
authors: Hamza
authors: H
authors: Alshuft
authors: Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, UK; Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK; Division of Clinical Neuroscience, Radiological Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
authors: Diane
authors: D
authors: Reckziegel
authors: Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, UK; Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK; Division of Clinical Neuroscience, Radiological Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
authors: Dorothee P
authors: DP
authors: Auer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000000981:diagnostic imaging / Q000209:etiology*; D001168:Arthritis / Q000150:complications*; D001921:Brain / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D059350:Chronic Pain / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D013113:Spin Labels; D064232:Visual Analog Scale
chemical_list: D013113:Spin Labels; D010100:Oxygen
keywords: Arterial spin labelling; Chronic pain; Knee osteoarthritis; Neuroimaging