Brain responses to vestibular pain and its anticipation in women with Genito-Pelvic Pain/Penetration Disorder

Els Pazmany, Huynh Giao Ly, Leen Aerts, Michiko Kano, Sophie Bergeron, Johan Verhaeghe, Ronald Peeters, Jan Tack, Patrick Dupont, Paul Enzlin, Lukas Van Oudenhove

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective In DSM-5, pain-related fear during anticipation of vaginal penetration is a diagnostic criterion of Genito-Pelvic Pain/Penetration Disorder (GPPPD). We aimed to investigate subjective and brain responses during anticipatory fear and subsequent induction of vestibular pain in women with GPPPD. Methods Women with GPPPD (n = 18) and age-matched healthy controls (HC) (n = 15) underwent fMRI scanning during vestibular pain induction at individually titrated pain threshold after a cued anticipation period. (Pain-related) fear and anxiety traits were measured with questionnaires prior to scanning, and anticipatory fear and pain intensity were rated during scanning using visual analog scales. Results Women with GPPPD reported significantly higher levels of anticipatory fear and pain intensity. During anticipation and pain induction they had stronger and more extensive brain responses in regions involved in cognitive and affective aspects of pain perception, but the group difference did not reach significance for the anticipation condition. Pain-related fear and anxiety traits as well as anticipatory fear ratings were positively associated with pain ratings in GPPPD, but not in HC. Further, in HC, a negative association was found between anticipatory fear ratings and brain responses in regions involved in cognitive and affective aspects of pain perception, but not in women with GPPPD. Conclusions Women with GPPPD are characterized by increased subjective and brain responses to vestibular pain and, to a lesser extent, its anticipation, with fear and anxiety associated with responses to pain, supporting the introduction of anticipatory fear as a criterion of GPPPD in DSM-5.

Original languageEnglish
Pages (from-to)477-490
Number of pages14
JournalNeuroImage: Clinical
Volume16
DOIs
Publication statusPublished - 2017

Keywords

  • Anticipation of pain
  • Genito-pelvic pain/penetration disorder
  • Pain-related fear and anxiety
  • Provoked vestibulodynia
  • Vestibular pain
  • fMRI

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Clinical Neurology
  • Cognitive Neuroscience

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    Pazmany, E., Ly, H. G., Aerts, L., Kano, M., Bergeron, S., Verhaeghe, J., Peeters, R., Tack, J., Dupont, P., Enzlin, P., & Van Oudenhove, L. (2017). Brain responses to vestibular pain and its anticipation in women with Genito-Pelvic Pain/Penetration Disorder. NeuroImage: Clinical, 16, 477-490. https://doi.org/10.1016/j.nicl.2017.07.017