Central Brain-Network Reorganization Underlying Relief of Primary Dysmenorrhea by Multimodal Peripheral Stimulation
Abstract: Background: Primary dysmenorrhea (PD) is a prevalent gynecological condition marked by recurring menstrual pain without identifiable pelvic disease. Although it has traditionally been attributed to uterine hypercontraction and prostaglandin activity, accumulating evidence points to central sensitization and disrupted large-scale brain networks. Abnormal activity has been reported in pain-processing regions including the anterior cingulate cortex (ACC), insula, thalamus, and prefrontal cortex (PFC). Multimodal peripheral stimulation offers a non-drug treatment option, but its influence on central neural organization remains insufficiently defined. Methods: The study enrolled 1,400 women, including 700 participants with PD and 700 healthy controls. Mechanical stimulation was combined with transcutaneous electrical nerve stimulation (TENS) to engage somatosensory afferents and peripheral-central pain-control pathways. Resting-state functional magnetic resonance imaging (rs-fMRI) was obtained before and after intervention. Region-of-interest functional connectivity and graph-theoretical measures were used to evaluate regional activity and whole-network organization. Pain intensity was recorded with the visual analog scale (VAS), and standard parametric analyses were performed with false discovery rate (FDR) correction at p
- Authors
- Jingyi Ruan