Aberrant resting-state cerebral blood flow and its connectivity in primary dysmenorrhea on arterial spin labeling MRI

Abstract Purpose The current study aimed to clarify resting-state cerebral blood flow alteration patterns in primary dysmenorrhea patients, investigate the relationships between cerebral blood flow alterations and clinical parameters and explore whether brain regions with abnormal cerebral blood flow also revealed functional connectivity changes. Methods The arterial spin labeling imaging and clinical parameters were acquired in forty-two primary dysmenorrhea patients and forty-one healthy controls during menstrual phase. Subsequently, the differences of cerebral blood flow were compared in two groups. Finally, the clusters with significant group differences were selected as the regions of interest to perform statistical analyses. Results Compared with healthy controls, primary dysmenorrhea patients exhibited increased cerebral blood flow in the bilateral precuneus, left posterior cingulate cortex, and right rolandic operculum. In the primary dysmenorrhea patients, significant negative correlation was identified between the cerebral blood flow of right rolandic operculum and the visual analogue score for anxiety. There was increased correlation between precuneus/posterior cingulate cortex and right middle cingulate cortex and between right rolandic operculum and left inferior parietal lobule and bilateral postcentral gyrus. Discussion Our findings suggested that brain regions of cerebral blood flow abnormalities were mainly concentrated in the default mode network in primary dysmenorrhea patients, which could be involved in central mechanism of primary dysmenorrhea. In addition, cerebral blood flow alteration in the rolandic operculum may be a compulsive tendency for anxiety. The enhancement of connectivity involved in various pain-related brain regions, which could contribute to the better understanding of generation and development in primary dysmenorrhea.