Psychotherapy with somatosensory stimulation for endometriosis-associated pain: the role of the anterior hippocampus
Background: Endometriosis is a gynecological disorder affecting 6%-10% of all women in their reproductive age. There is an emerging view in the literature that psychological trauma plays a central role in the pathogenesis of pelvic pain, one of the core symptoms of endometriosis. Here we report cent...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
15 November 2018
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| In: |
Biological psychiatry
Year: 2018, Volume: 84, Issue: 10, Pages: 734-742 |
| ISSN: | 1873-2402 |
| DOI: | 10.1016/j.biopsych.2017.01.006 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1016/j.biopsych.2017.01.006 Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0006322317300380 
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| Author Notes: | Florian Beissner, Christine Preibisch, Annemarie Schweizer-Arau, Roxana M. Popovici, and Karin Meissner |
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| 245 | 1 | 0 | |a Psychotherapy with somatosensory stimulation for endometriosis-associated pain |b the role of the anterior hippocampus |c Florian Beissner, Christine Preibisch, Annemarie Schweizer-Arau, Roxana M. Popovici, and Karin Meissner |
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| 520 | |a Background: Endometriosis is a gynecological disorder affecting 6%-10% of all women in their reproductive age. There is an emerging view in the literature that psychological trauma plays a central role in the pathogenesis of pelvic pain, one of the core symptoms of endometriosis. Here we report central nervous system mechanisms of a novel combination of psychotherapy and somatosensory stimulation that has recently shown remarkable effects in reducing pain, anxiety, and depressive symptoms in these patients. Methods: We conducted a randomized controlled trial; 67 patients with severe endometriosis-associated pain (maximum pain: 7.6 ± 2.0, average pain: 4.5 ± 2.0 on a 10-point numeric rating scale) were included in the study and randomly allocated to intervention (35 patients) or waitlist control (32 patients) groups. Resting-state functional magnetic resonance imaging was used to assess brain connectivity of these patients at baseline, after 3 months of therapy, and after 6 months. The analysis focused on the hippocampus. Results: We identified a cortical network comprising the right anterolateral hippocampus—a region modulating the hypothalamic-pituitary-adrenal axis—and somatosensory, viscerosensory, and interoceptive brain regions. Regression analysis showed that reduction in connectivity predicted therapy-induced improvement in patients׳ anxiety. Conclusions: We have identified a putative neurobiological mechanism underlying the potent combination of psychotherapy and somatic stimulation in treating symptoms of endometriosis. | ||
| 650 | 4 | |a Acupuncture | |
| 650 | 4 | |a Anxiety | |
| 650 | 4 | |a Endometriosis | |
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| 650 | 4 | |a Masked independent component analysis | |
| 650 | 4 | |a Pelvic pain | |
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