HIV Distal Neuropathic Pain Is Associated with Smaller Ventral Posterior Cingulate Cortex.

TitleHIV Distal Neuropathic Pain Is Associated with Smaller Ventral Posterior Cingulate Cortex.
Publication TypeJournal Article
Year of Publication2017
AuthorsKeltner, JR, Connolly, CG, Vaida, F, Jenkinson, M, Fennema-Notestine, C, Archibald, SL, Akkari, C, Schlein, A, Lee, J, Wang, D, Kim, S, Li, H, Rennels, A, Miller, DJ, Kesidis, G, Franklin, D, Sanders, C, Corkran, S, Grant, I, Brown, GG, Atkinson, JH, Ellis, RJ
Corporate AuthorsCHARTER Group
JournalPain Med
Date Published2017 03 01
KeywordsAdult, Aged, CHARTER, Female, Gray Matter, Gyrus Cinguli, HIV Infections, Humans, Image Interpretation, Computer-Assisted, Internal, Magnetic Resonance Imaging, Male, Middle Aged, Neuralgia, Young Adult

Objective: . Despite modern antiretroviral therapy, HIV-associated neuropathy is one of the most prevalent, disabling and treatment-resistant complications of HIV disease. The presence and intensity of distal neuropathic pain is not fully explained by the degree of peripheral nerve damage. A better understanding of brain structure in HIV distal neuropathic pain may help explain why some patients with HIV neuropathy report pain while the majority does not. Previously, we reported that more intense distal neuropathic pain was associated with smaller total cerebral cortical gray matter volumes. The objective of this study was to determine which parts of the cortex are smaller.Methods: . HIV positive individuals with and without distal neuropathic pain enrolled in the multisite (N = 233) CNS HIV Antiretroviral Treatment Effects (CHARTER) study underwent structural brain magnetic resonance imaging. Voxel-based morphometry was used to investigate regional brain volumes in these structural brain images.Results: . Left ventral posterior cingulate cortex was smaller for HIV positive individuals with versus without distal neuropathic pain (peak P  = 0.017; peak t = 5.15; MNI coordinates x = -6, y = -54, z = 20). Regional brain volumes within cortical gray matter structures typically associated with pain processing were also smaller for HIV positive individuals having higher intensity ratings of distal neuropathic pain.Conclusions: . The posterior cingulate is thought to be involved in inhibiting the perception of painful stimuli. Mechanistically a smaller posterior cingulate cortex structure may be related to reduced anti-nociception contributing to increased distal neuropathic pain.

Alternate JournalPain Med
PubMed ID27497320
PubMed Central IDPMC6074843
Grant ListK23 NS079311 / NS / NINDS NIH HHS / United States
P30 MH062512 / MH / NIMH NIH HHS / United States
P50 DA026306 / DA / NIDA NIH HHS / United States
R01 MH107345 / MH / NIMH NIH HHS / United States