Altered amygdalar volume and functional connectivity in primary dysmenorrhoea during the menstrual cycle

Abstract

Background Primary dysmenorrhoea (PDM), characterized as menstrual pain without pelvic pathology, is associated with pain‐related negative mood and hormone fluctuations. Previous studies strongly supported the link between pain and negative mood in affected individuals; however, it remains largely unknown in patients with PDM. Methods We focused on the effects how spontaneous pain, negative mood and hormone levels played on the central nervous system in 34 PDM women and 33 matched healthy controls across their cycles (periovulatory phase and menstruation phase) by using T1‐weighted and functional imaging. Voxel‐based morphometry and functional connectivity (FC) analyses were performed to evaluate brain structural and functional changes. Hormone concentrations (oestradiol, progesterone and cortisol) were also obtained. Results Abnormal state‐related GM volume in the amygdala was found between periovulatory and menstruation phases in PDM. Furthermore, larger amygdalar volume was observed in patients’ menstruation phase, which was significantly correlated with higher levels of cortisol. In addition, we found increased amygdala‐seeded FC in vlPFC, which may be associated with pain intensity and negative mood in PDM women during the pain state. Conclusions Taken together, we found women with PDM had structural and functional abnormalities in the amygdala, which associated with stress hormone levels, pain intensity and negative mood, may reflect disturbed emotional and pain modulation in women with PDM. Significance Our findings provide further evidence of amygdala‐related abnormalities, which may be associated with pain‐related affective distress and hormonal fluctuations in women with PDM, and complement the brain mechanism investigations for the pathophysiology of PDM.

Effects of repeated menstrual pain on empathic neural responses in women with primary dysmenorrhea across the menstrual cycle

“…and (d) their average cramping pain intensity in the last 6 months was rated >4 (0 = not at all, 10 = the worst pain). The PDM individuals were screened and diagnosed by a gynecologist from the Department of Obstetrics and Gynecology at the First Affiliated Hospital of the Medical College of Xi'an Jiaotong University (L. Yang et al, 2019).…”

“…Primary dysmenorrhea (PDM) is classified as a chronic pelvic pain syndrome. In female adolescents, it is a very common cyclic menstrual pain without pelvic pathology (Low et al, 2018;L. Yang et al, 2019).…”

“…Women with PDM are often accompanied by physiological disorders and negative emotions (Low et al, 2018;L. Yang et al, 2019), which may make it difficult for people to use emotional-communicative information to infer pain in others (Preis, Schmidt-Samoa, Dechent, & Kroener-Herwig, 2013).…”

Association Between Trait Empathy and Resting Brain Activity in Women With Primary Dysmenorrhea During the Pain and Pain-Free Phases

“…Primary dysmenorrhea (PDM), a very common type of cyclic menstrual pain without organic causes in female adolescents, induces recurrent, spontaneous, painful and pain-free states (10). Women with PDM have a poorer mood state during menstruation than preovulatory phases (11). Hence, PDM can be used as a great clinical model to study both the effects of long-term menstrual pain on empathy and the difference of the empathy between painful and pain-free states.…”

Getting Rid of “Bomb Pushing the Womb”: Dysmenorrhea Management-Mini Review

“…Payne et al stated that primary dysmenorrhea (PDM) is associated with enhanced pain sensitivity and temporal summation in adult women, which may reflect the presence of central pain processes [17]. Also, Yang et al [18] concluded that women with PDM had structural and functional abnormalities in the amygdala, which associated with stress hormone levels, pain intensity and negative mood, may reflect disturbed emotional and pain modulation in women with PDM [18]. Dysmenorrhea was considerably higher in girls who were consistently eating fast food.…”