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Altered structural connectivity of pain-related brain network in burning mouth syndrome—investigation by graph analysis of probabilistic tractography

  • Functional Neuroradiology
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Abstract

Purpose

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.

Conclusion

Structural brain network analysis revealed the alteration of the medial system of the pain-related brain network in chronic pain syndrome.

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Abbreviations

BMS:

Burning mouth syndrome

ACC:

Anterior cingulate cortex

PFC:

Prefrontal cortex

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Authors and Affiliations

  1. Department of Radiology, Nihon University School of Medicine, 30-1 Oyamaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan

    Akihiko Wada, Takashi Shizukuishi, Junko Kikuta, Haruyasu Yamada, Yusuke Watanabe, Hiroki Haradome & Osamu Abe

  2. Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Yusuke Watanabe & Osamu Abe

  3. Department of Dentistry, Nihon University School of Medicine, Tokyo, Japan

    Yoshiki Imamura, Takahiro Shinozaki & Ko Dezawa

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  1. Akihiko Wada
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  2. Takashi Shizukuishi
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  3. Junko Kikuta
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  4. Haruyasu Yamada
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  7. Takahiro Shinozaki
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  9. Hiroki Haradome
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  10. Osamu Abe
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Correspondence to Akihiko Wada.

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Funding

This study was funded by a Japan Society for the Promotion of Science Grant-in-Aid for Scientific Research to OA (grant number 16K10330), Grants-in-Aid for Scientific Research to YI (grant number 15K11326), a Uemura Fund Research Grant to YI and Grants-in-Aid for Scientific Research to TS (grant number 16K11897).

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Nihon University Hospitals’ Joint Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Wada, A., Shizukuishi, T., Kikuta, J. et al. Altered structural connectivity of pain-related brain network in burning mouth syndrome—investigation by graph analysis of probabilistic tractography. Neuroradiology 59, 525–532 (2017). https://doi.org/10.1007/s00234-017-1830-2

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