Altered resting-state functional connectivity of default mode network in brachioradial pruritus.

BACKGROUND: Patients with chronic pruritus (CP) have a low quality of life, thus it is important to gain a better understanding of the underlying processes. Previous functional magnetic resonance imaging studies at rest (rsfMRI) have shown that mainly areas associated with the default mode network (DMN), sensorimotor (SMN), frontoparietal (FPN) and salience networks (SN) are involved in the processing of itch in patients with chronic pruritus (CP), as well as the cortico-striatal circuit, which is involved in the motoric preparation of scratching. rsfMRI studies on functional connectivity (FC) patterns of resting-state networks (RSNs) in patients with inflammatory atopic dermatitis (AD) or with neuropathic brachioradial pruritus (BRP) compared with healthy controls (HC) are lacking. OBJECTIVES: The main goals of this study were to investigate whether functional connectivity within networks and areas associated with itch detection and processing are altered in patients with AD and BRP compared with matched healthy controls by rsfMRI, respectively. METHODS: Patients with AD (n = 28) and with BRP (n = 28) were compared with corresponding matched healthy controls by rsfMRI. Group-specific RSNs were identified by independent component analysis (ICA) and between-group differences in the RSNs were analysed by dual regression technique. Seed-based functional connectivity was analysed in several itch-related brain regions belonging to the DMN, SN and FPN, respectively. RESULTS: ICA and seed-based analyses revealed decreased functional connectivity in BRP compared with HC specially within the DMN including the precuneus and cingulate cortex. For AD patients in comparison with HC, as well as when BRP and AD patients were compared directly, no significant FC differences at rest were seen. CONCLUSIONS: Our findings point towards decreased FC particularly in the DMN at rest in patients with BRP. These results seem to indicate that central connectivity patterns at rest differentially encode itch in BRP and AD.

Structural changes in brain morphology induced by brief periods of repetitive sensory stimulation.

There is a growing interest in identifying the neural mechanisms by which the human brain allows for improving performance. Tactile perceptual measurements, e.g. two-point discrimination (2ptD), can be used to investigate neural mechanisms of perception as well as perceptual improvement. Improvement can be induced in a practice-independent manner, e.g. in the tactile domain through repetitive somatosensory stimulation (rSS). With respect to tactile perception, the role of cortical excitability and activation within the somatosensory cortex has been investigated extensively. However, the role of structural properties, such as regional gray matter (GM) volume, is unknown. Using high resolution imaging and voxel-based morphometry (VBM), we sought to investigate how regional GM volume relates to individual 2ptD performance. Furthermore, we wanted to determine if electrical rSS has an influence on regional GM volume. 2ptD thresholds of the index fingers were assessed bilaterally. High-resolution (1 mm3), T1-weighted images were obtained using a 3T scanner pre-and post-stimulation. RSS was applied for 45 min to the dominant right hand, specifically to the fingertips of all fingers. At baseline, performance in the 2ptD task was associated with regional GM volume in the thalamus, primary somatosensory cortex, and primary visual cortex (negative association). After 45 min of rSS, we observed an improvement in 2ptD of the stimulated hand, whereas no improvement in tactile performance was seen on the non-stimulated side. These perceptual changes were accompanied by an increase in GM volume in the left somatosensory cortex and the degree of improvement correlated with GM volume changes in the insular cortex. Our results show that structural changes in the brain, specifically in regions receiving afferent input from the stimulated body site can be induced via a short-term intervention lasting only 45 min. However, the neurobiological correlates of these changes and the dynamics need to be further elucidated.