Subcortical brain anatomy as a potential biomarker of persistent pain after total knee replacement in osteoarthritis

• Tipo: Artigo em Revista Científica Internacional
• Data: 2023

Autores

Barroso, J (Autor) Outra; Branco, P (Autor) Outra; Pinto-Ramos, J (Autor) Outra; Vigotsky, AD (Autor) Outra; Reis, AM (Autor) Outra; Schnitzer, TJ (Autor) Outra; Vasco Galhardo (Autor) FMUP; Apkarian, AV (Autor) Outra

Revista

Título: Pain

Vol. 164

Páginas: 2306-2315

ISSN: 0304-3959

Editora: Wolters Kluwer Health

Indexação

ISI Web of Knowledge - 0 Citações

Scopus - 0 Citações

Outras Informações

ID Authenticus: P-00Z-2MG

DOI: 10.1097/j.pain.0000000000002932

Abstract (EN): Osteoarthritis pain persistence after joint replacement is associated with presurgical brain subcortical volumes (bilateral amygdala, thalamus, and left hippocampus), together with shape deformations of the right anterior hippocampus and right amygdala. The neural mechanisms for the persistence of pain after a technically successful arthroplasty in osteoarthritis (OA) remain minimally studied, and direct evidence of the brain as a predisposing factor for pain chronicity in this setting has not been investigated. We undertook this study as a first effort to identify presurgical brain and clinical markers of postarthroplasty pain in knee OA. Patients with knee OA (n = 81) awaiting total arthroplasty underwent clinical and psychological assessment and brain magnetic resonance imagining. Postoperative pain scores were measured at 6 months after surgery. Brain subcortical anatomic properties (volume and shape) and clinical indices were studied as determinants of postoperative pain. We show that presurgical subcortical volumes (bilateral amygdala, thalamus, and left hippocampus), together with shape deformations of the right anterior hippocampus and right amygdala, associate with pain persistence 6 months after surgery in OA. Longer pain duration, higher levels of presurgical anxiety, and the neuropathic character of pain were also prognostic of postsurgical pain outcome. Brain and clinical indices accounted for unique influences on postoperative pain. Our study demonstrates the presence of presurgical subcortical brain factors that relate to postsurgical persistence of OA pain. These preliminary results challenge the current dominant view that mechanisms of OA pain predominantly underlie local joint mechanisms, implying novel clinical management and treatment strategies.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 10