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Brain responses to vestibular pain and its anticipation in women with Genito-Pelvic Pain/Penetration Disorder

Authors :
Els Pazmany
Huynh Giao Ly
Leen Aerts
Michiko Kano
Sophie Bergeron
Johan Verhaeghe
Ronald Peeters
Jan Tack
Patrick Dupont
Paul Enzlin
Lukas Van Oudenhove
Source :
NeuroImage: Clinical, Vol 16, Iss , Pp 477-490 (2017)
Publication Year :
2017
Publisher :
Elsevier, 2017.

Abstract

Objective: In DSM-5, pain-related fear during anticipation of vaginal penetration is a diagnostic criterion of Genito-Pelvic Pain/Penetration Disorder (GPPPD). We aimed to investigate subjective and brain responses during anticipatory fear and subsequent induction of vestibular pain in women with GPPPD. Methods: Women with GPPPD (n=18) and age-matched healthy controls (HC) (n=15) underwent fMRI scanning during vestibular pain induction at individually titrated pain threshold after a cued anticipation period. (Pain-related) fear and anxiety traits were measured with questionnaires prior to scanning, and anticipatory fear and pain intensity were rated during scanning using visual analog scales. Results: Women with GPPPD reported significantly higher levels of anticipatory fear and pain intensity. During anticipation and pain induction they had stronger and more extensive brain responses in regions involved in cognitive and affective aspects of pain perception, but the group difference did not reach significance for the anticipation condition. Pain-related fear and anxiety traits as well as anticipatory fear ratings were positively associated with pain ratings in GPPPD, but not in HC. Further, in HC, a negative association was found between anticipatory fear ratings and brain responses in regions involved in cognitive and affective aspects of pain perception, but not in women with GPPPD. Conclusions: Women with GPPPD are characterized by increased subjective and brain responses to vestibular pain and, to a lesser extent, its anticipation, with fear and anxiety associated with responses to pain, supporting the introduction of anticipatory fear as a criterion of GPPPD in DSM-5. Keywords: Anticipation of pain, Pain-related fear and anxiety, Vestibular pain, fMRI, Genito-pelvic pain/penetration disorder, Provoked vestibulodynia

Details

Language :
English
ISSN :
22131582
Volume :
16
Issue :
477-490
Database :
Directory of Open Access Journals
Journal :
NeuroImage: Clinical
Publication Type :
Academic Journal
Accession number :
edsdoj.76c44c43ce54601aa83c82de03ab9fd
Document Type :
article
Full Text :
https://doi.org/10.1016/j.nicl.2017.07.017