Clinical vitamin D levels are associated with insular volume and inferior temporal gyrus white matter surface area in community-dwelling individuals with knee pain

Abstract

ContextVitamin D is an essential, fat soluble micronutrient long-known for its effects on calcium homeostasis and bone health. With advances in technology, it is being discovered that Vitamin D exerts its effects beyond the musculoskeletal system. Vitamin D has since been noted in nervous system health and functioning, and is becoming a target of interest in brain health, aging, and chronic pain outcomes.ObjectivesWe and others have previously shown that deficient Vitamin D status is associated with greater pain severity across a variety of conditions, however the reason as to why this relationship exists is still being understood. Here, we sought to examine associations between Vitamin D status and brain structure in those with chronic knee pain.MethodsStructural MRI imaging techniques and whole brain analyses were employed and serum Vitamin D were collected on 140 participants with chronic pain. Covariates included age, sex, race and site, as these data were collected at two separate institutions. ANOVAs using the clinical cut points for Vitamin D status (deficient, insufficient, and optimal) as well as continuous regression-based Vitamin D effects were employed to observe differences in brain volume. P-value was set to 0.017 after correction for multiple comparisons.ResultsWe discovered that individuals in our sample (age = 50+; 63.6% female; 52.1% Non-Hispanic Black) who were either clinically deficient (<20 ng/mL) or insufficient (20–30 ng/mL) in serum Vitamin D had significant differences in the gray matter of the left circular insular cortex, left inferior temporal gyrus, right middle temporal gyrus, as well as decreased white matter surface area in the right inferior temporal gyrus compared to those considered to have optimal levels (>30 ng/mL) of serum Vitamin D.ConclusionEvidence from these data suggests that Vitamin D, or lack thereof, may be associated with pain outcomes by mediating changes in regions of the brain known to process and interpret pain. More research understanding this phenomenon as well as the effects of Vitamin D supplementation is warranted.

The Role of the Insula in Chronic Pain and Associated Structural Changes: An Integrative Review

“…Neuroimaging studies have consistently shown insular activation across various noxious modalities and body parts, indicating its role as a central hub for processing pain stimuli regardless of the source [ 52 ]. Functional magnetic resonance imaging offers a non-invasive means of measuring neuronal activity in the human brain by detecting changes in activity and generating signals.…”

Pain-sensorimotor interactions: New perspectives and a new model

“…Many environmental factors may influence pain and/or sensorimotor behavior. And as in animal models, environmental factors range widely in humans, and include the chemical composition and physical features of the diet, drugs of abuse, toxins, level of physical activity, training and fitness, past pain history, social stressors, sociocultural factors, adverse life circumstances, sleep disruption, and gender roles and expectations, to injury, inflammation, diseases, muscle atrophy, and other alterations of peripheral tissues which can lead to pain ( Sanford et al, 2002 , Wise et al, 2002 , Davidson and McEwen, 2012 , Finan et al, 2013 , Fillingim, 2017 , Bjørklund et al, 2019 , Polli et al, 2019 , Lesnak and Sluka, 2020 , Sessle, 2021 , Strath et al, 2022 , Lesnak et al, 2023 ). While many of these factors have not been specifically studied in relation to pain-related sensorimotor behaviors in humans, some of these factors have been shown to contribute to the sex and inter-individual differences in pain sensitivity and sensorimotor behaviors noted above ( Mogil, 2012b , Mogil, 2020 , Sawicki et al, 2021 ).…”

Emergencias asociadas a la paratiroides: una revisión narrativa

“…• La PTH actúa sobre el túbulo proximal, la porción ascendente del asa de Henle y el túbulo contorneado distal, promoviendo la reabsorción rápida de calcio. La reabsorción de calcio en el riñón se modula mediante PTH, 1,25(OH)2D3 y estrógenos; reduciendo la expresión de los niveles de TRPV5, calbindina D28k, PMCA1b y NCX1 en las células renales (4,5).…”

“…El calcio sérico está ligado a proteínas (principalmente albumina) en un 40%, a aniones como citrato, sulfato o fosfato en un 9% o en un estado ionizado 33%. Siendo el calcio ionizado (biológicamente activo) la forma viable para la activación de procesos fisiológicos esenciales, sus valores normales son 4,6 -5,0 mg/dl y 1,15 a 1,25 mmol/L (1)(2)(3)(4) . El calcio además de contribuir en la rigidez y densidad ósea también ejerce acciones sobre la función neuromuscular, la cascada de coagulación, la permeabilidad celular, la activación enzimática, el funcionamiento hormonal y la muerte celular programada (5,6).…”