title: Altered structural connectivity of pain-related brain network in burning mouth syndrome-investigation by graph analysis of probabilistic tractography.
abstract: OBJECTIVE
  Burning mouth syndrome (BMS) is a chronic intraoral pain syndrome featuring idiopathic oral pain and burning discomfort despite clinically normal oral mucosa. The etiology of chronic pain syndrome is unclear, but preliminary neuroimaging research has suggested the alteration of volume, metabolism, blood flow, and diffusion at multiple brain regions. According to the neuromatrix theory of Melzack, pain sense is generated in the brain by the network of multiple pain-related brain regions. Therefore, the alteration of pain-related network is also assumed as an etiology of chronic pain. In this study, we investigated the brain network of BMS brain by using probabilistic tractography and graph analysis.
  
  
  METHODS
  Fourteen BMS patients and 14 age-matched healthy controls underwent 1.5T MRI. Structural connectivity was calculated in 83 anatomically defined regions with probabilistic tractography of 60-axis diffusion tensor imaging and 3D T1-weighted imaging. Graph theory network analysis was used to evaluate the brain network at local and global connectivity.
  
  
  RESULTS
  In BMS brain, a significant difference of local brain connectivity was recognized at the bilateral rostral anterior cingulate cortex, right medial orbitofrontal cortex, and left pars orbitalis which belong to the medial pain system; however, no significant difference was recognized at the lateral system including the somatic sensory cortex. A strengthened connection of the anterior cingulate cortex and medial prefrontal cortex with the basal ganglia, thalamus, and brain stem was revealed.
  
  
  CONCLUSIONS
  Structural brain network analysis revealed the alteration of the medial system of the pain-related brain network in chronic pain syndrome.
authors.affiliation: Department of Radiology, Nihon University School of Medicine, 30-1 Oyamaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan. awada-ind@umin.net.
authors.forename: Akihiko
authors.identifier: http://orcid.org/0000-0003-3432-0267
authors.initials: A
authors.lastname: Wada
authors.affiliation: Department of Radiology, Nihon University School of Medicine, 30-1 Oyamaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Shizukuishi
authors.affiliation: Department of Radiology, Nihon University School of Medicine, 30-1 Oyamaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Kikuta
authors.affiliation: Department of Radiology, Nihon University School of Medicine, 30-1 Oyamaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Haruyasu
authors.initials: H
authors.lastname: Yamada
authors.affiliation: Department of Radiology, Nihon University School of Medicine, 30-1 Oyamaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.|Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Department of Dentistry, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Imamura
authors.affiliation: Department of Dentistry, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Shinozaki
authors.affiliation: Department of Dentistry, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Ko
authors.initials: K
authors.lastname: Dezawa
authors.affiliation: Department of Radiology, Nihon University School of Medicine, 30-1 Oyamaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Haradome
authors.affiliation: Department of Radiology, Nihon University School of Medicine, 30-1 Oyamaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.|Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Abe
mesh_terms: D000328:Adult; D000368:Aged; D001931:Brain Mapping / Q000379:methods*; D002054:Burning Mouth Syndrome / Q000503:physiopathology*; D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D010147:Pain Measurement
keywords: Burning mouth syndrome; Chronic pain; Diffusion tensor imaging; Probabilistic tractography; Structural brain connectivity: graph theory network analysis