The 12th Invest in ME Conference, Part 1
OverTheHills presents the first article in a series of three about the recent 12th Invest In ME international Conference (IIMEC12) in London.
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Resting-State Functional Connectivity Predicts Longitudinal Pain Symptom Change In Urologic ...

Discussion in 'Other Health News and Research' started by Kati, Mar 24, 2017.

  1. Kati

    Kati Patient in training

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    Resting-State Functional Connectivity Predicts Longitudinal Pain Symptom Change In Urologic Chronic Pelvic Pain Syndrome: A Mapp Network Study

    Kutch JJ1, Labus JS, Harris RE, Martucci KT, Farmer MA, Fenske S, Fling C, Ichesco E, Peltier S, Petre B, Guo W, Hou X, Stephens AJ, Mullins C, Clauw DJ, Mackey SC, Apkarian AV, Landis JR, Mayer EA; MAPP Research Network.

    Author information
    1Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA. 2G Oppenheimer Center for Neurobiology of Stress and Resilience, Pain and Interoception Network (PAIN), David Geffen School of Medicine at UCLA, Los Angeles, CA, USA 3Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, USA. 4Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Stanford University Medical Center, Stanford, CA, USA. 5Department of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA. 6Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA. 7Functional MRI Laboratory, University of Michigan, Ann Arbor, MI, USA. 8Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. 9National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USA.


    Abstract

    Chronic pain symptoms often change over time, even in individuals who have had symptoms for years.

    Studying biological factors that predict trends in symptom change in chronic pain may uncover novel pathophysiological mechanisms and potential therapeutic targets.

    In this study, we investigated whether brain functional connectivity measures obtained from resting-state functional MRI (rs-fMRI) at baseline can predict longitudinal symptom change (3, 6, and 12 months post-scan) in urologic chronic pelvic pain syndrome (UCPPS).

    We studied 52 individuals with UCPPS (34 female, 18 male) who had baseline neuroimaging followed by symptom tracking every 2 weeks for 1 year as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network study.

    We found that brain functional connectivity can make a significant prediction of short-term (3 month) pain reduction with 73.1% accuracy (69.2% sensitivity and 75.0% precision).

    Additionally, we found that the brain regions with greatest contribution to the classification were preferentially aligned with the left frontoparietal network (L-FPN). rs-fMRI measures appeared to be less informative about 6 or 12 month symptom change.

    Our study provides the first evidence that future trends in symptom change in patients in a state of chronic pain may be linked to functional connectivity within specific brain networks.



     
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  2. RogerBlack

    RogerBlack Senior Member

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    I note the related older paper on https://www.scientificamerican.com/article/london-taxi-memory/

    This found that you can accurately predict if someone is going to be able to complete training to become a taxi driver (with required knowledge of london) partway through the trial) as the requisite area of the brain was growing.
    Of course, it will be tempting for some to jump on the fact that it's brain changes, and hence amenable to treatment with CBT et-al with no evidence.
     
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  3. Woolie

    Woolie Gone now, hope to see you all again soon somewhere

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    @Kati, I had a look at the full-text. Its very weird. They found that certain patterns of resting state activity were predictive of how much people's pain changed within the next three months. That sounds impressive, eh? But then the patterns didn't predict pain at six months and 12 months!

    I suspect instead that what they measured was actual baseline pain, rather than improvement - because these two variables will be most tightly correlated at 3 months, and less so at 6 and 12 months. The relationship betwen baseline pain and 3 month improvement is probably a statistical artefact. Sometimes, those that are worse at baseline are more likely o improve just due to regression to the mean. Other times, being worse at baseline means you have a more severe version of the condition, so you will improve less. I cant see anywhere in the paper where they have explore these important issues. But safe to say, they haven't provided any convincing evidence of "prediction" at all!

    Then there's this:
    What they actually found was that a massive frontal network involved in all sorts of clever stuff was more active at rest in "improvers". And a network of more posterior structures was more active at rest in "non improvers". There is simply no way you can take this data and infer that if indicates "beliefs"!!!

    These authors believe that this urinary condition is "real" (has a biological basis), but still they profess a key role for beliefs. Imagine what they would do with an illness they don't think is "real"!
     
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  4. Kati

    Kati Patient in training

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    Thank you so much for your comments. This is very insightful. I am loosely following IC because like ME there are much beliefs that 'it's all in the head", and how they associate it to other vague symptoms, chronic pain, fibro and ME. looking at the. MAPP network website can be viewed here. While they are doing valuable research at the biological level, they are also looking at behavioral aspect. This quote is towards the bottom of the page of the 'about' section:

    Like I said, worth keeping an eye.

    Have you thought of submitting these comments to the journal? In my opinion it would be worthy of doing.
     
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  5. Woolie

    Woolie Gone now, hope to see you all again soon somewhere

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    I'm not sure I would be confident to do that. Plus, this was based on a quick read, I would have to read much more carefully and do it proper justice.
     

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