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Altered amplitude of low-frequency fluctuation and regional cerebral blood flow in females with primary dysmenorrhea: a resting-state fMRI and arterial spin labeling study

Authors Zhang YN, Huo JW, Huang YR, Hao Y, Chen ZY

Received 17 June 2018

Accepted for publication 14 February 2019

Published 16 April 2019 Volume 2019:12 Pages 1243—1250


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Michael A Überall

Ya-Nan Zhang,1 Jian-Wei Huo,1 Yi-Ran Huang,2 Ying Hao,3 Zi-Yue Chen4

1Department of Radiology, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing 100010, People’s Republic of China; 2School of Acupuncture-Moxibustion & Tuina, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China; 3Beijing International Center for Mathematical Research, Peking University, Beijing 100871, People’s Republic of China; 4Department of Acupuncture and Moxibustion, Yanshan Hospital, Beijing 102500, People’s Republic of China

Purpose: The current study aimed to explore the central mechanism of primary dysmenorrhea (PD) by investigating the alterations in resting state amplitude of low-frequency fluctuation (ALFF) and regional cerebral blood flow (CBF) between PD patients and healthy controls (HCs).
Patients and methods: A total of 34 female subjects including 20 PD patients and 14 HCs underwent resting-state functional magnetic resonance imaging (rs-fMRI) and arterial spin labeling technique (ASL) MRI during menstrual phase. Subsequently, the differences in ALFF and CBF were compared in the two groups. The visual analog scores for pain (VAS-P) and for anxiety (VAS-A) were applied to assess cramping pain and related symptoms in PD patients. Finally, Pearson’s correlation analysis was performed to analyze relationships between the neuroimaging findings and clinical characteristics.
Results: Compared to HCs, PD patients had decreased ALFF in the right cerebellum posterior lobe, right middle temporal gyrus, right parahippocampal gyrus, right hippocampus, right brainstem and left parietal lobe. In addition, elevated CBF values were observed in the right inferior frontal gyrus, right precentral gyrus, and right superior temporal gyrus. There was no significant correlation between ALFF, CBF values and clinical characteristics including onset age of dysmenorrhea, VAS-A, and VAS-P in PD patients.
Conclusion: The preliminary alterations of ALFF and CBF values in PD patients were observed in different pain-related brain regions, which were involved in multiple dimensions of pain and pain modulation. The combination of rs-fMRI and ASL MRI might provide complementary information for a better understanding of the central mechanism in PD.

Keywords: primary dysmenorrhea, resting state functional magnetic resonance imaging, amplitude of low frequency fluctuation, arterial spin labeling, cerebral blood flow

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