Psychotherapy with somatosensory stimulation for endometriosis-associated pain

• Verfasst von: Beißner, Florian [VerfasserIn]
• Verfasst von: Popovici, Roxana [VerfasserIn]
• Titel: Psychotherapy with somatosensory stimulation for endometriosis-associated pain
• Titelzusatz: the role of the anterior hippocampus
• Verf.angabe: Florian Beissner, Christine Preibisch, Annemarie Schweizer-Arau, Roxana M. Popovici, and Karin Meissner
• E-Jahr: 2018
• Jahr: 15 November 2018
• Umfang: 9 S.
• Teil: volume:84
• Teil: year:2018
• Teil: number:10
• Teil: pages:734-742
• Teil: extent:9
• Fussnoten: Available online 16 January 2017 ; Gesehen am 11.03.2020
• Titel Quelle: Enthalten in: Biological psychiatry
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1985
• Jahr Quelle: 2018
• Band/Heft Quelle: 84(2018), 10, Seite 734-742
• ISSN Quelle: 1873-2402
• DOI: doi:10.1016/j.biopsych.2017.01.006
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Acupuncture
• Sach-SW: Anxiety
• Sach-SW: Endometriosis
• Sach-SW: Functional connectivity
• Sach-SW: Hippocampus
• Sach-SW: Masked independent component analysis
• Sach-SW: Pelvic pain
• K10plus-PPN: 1581618069

Abstract

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.