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Title: Neuroimaging functional pain networks in health and disease
Author: Brawn, Jennifer
ISNI:       0000 0004 7229 5645
Awarding Body: University of Oxford
Current Institution: University of Oxford
Date of Award: 2017
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Chronic pelvic pain (CPP) is considered a significant public health problem. In the United Kingdom, it has been estimated that 24% of women suffer from CPP. Using neuroimaging, this dissertation aims to characterise the pain experience by examining functional changes in critical pain networks. I begin by examining the functional correlates of capsaicin-induced central sensitisation in healthy individuals. Most of the results did not reach significance, largely due to the use of early 7T data and small sample sizes. In an exploratory analysis, amygdala - anterior insula connectivity is positively correlated with pain intensity. The remaining experimental chapters examine mechanisms of pain in women with CPP. I begin by attempting to better characterise this diverse patient population. I demonstrate correlations between measures of the pain experience and psychological scores. Following this, I examine clinically-relevant changes in functional connectivity. I demonstrate that there are potentially different underlying modulatory mechanisms in women with neuropathic components to their pelvic pain. Furthermore, women who experience pain for longer than 24 months have increased functional connectivity between the hippocampus and periaqueductal gray, suggesting pain-related alterations in central circuitry. The final experimental chapters explore surgical and pharmaceutical treatments for CPP and endometriosis; however, due to small sample sizes and nonsignificant findings, limited conclusions can be drawn from the results. In this dissertation, I found changes in important pain networks that could either represent the maintenance of the pain state or are consequence of the pain itself. These findings may serve as an indicator of underlying central changes that relate to relevant components of the clinical pain experience.
Supervisor: Vincent, Katy ; Tracey, Irene Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available