Pain research & management · 2026
Iron-Sensitive MRI Reveals Individual Differences in Pain Modulation Rather Than Categorical Markers in Chronic Pain and Migraine.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ydlibi Omar, Salehi Ravesh Mona, Bernerth Florian, Maedler Burkhard, Jansen Olav, Gierthmühlen Janne, Peters Sönke
Аннотация
OBJECTIVE: To determine whether regional iron levels are associated with endogenous pain-inhibitory function and whether iron-sensitive MRI techniques, quantitative magnetic susceptibility (QSM) and R 2 ∗ mapping capture differences in midbrain iron content in the globus pallidus (GP), periaqueductal grey (PAG), and red nucleus (RN) across chronic pain (CP), migraineurs (M), and healthy volunteers (HV).
METHODS: Sixty participants (20 CP, 20 M, and 20 HV) underwent a 3T MRI examination. Pain modulatory and autonomic function was assessed using conditioned pain modulation (CPM) and pupil reflex dilation (PRD) across all participants (n = 60), whereas quantitative sensory testing (QST) and pain sensitivity questionnaire (PSQ) were assessed in CP and M only (n = 40). Group differences and iron-pain relationships were evaluated using ANOVA or Kruskal-Wallis tests and linear regression models.
RESULTS: Distinct region- and modality-specific relationships were observed between iron-sensitive MRI measures and pain-related outcomes. R 2 ∗ RN was associated with absolute and relative CPM effects. QSM PAG was associated with temporal summation and showed a trend-level association with subjective pain sensitivity (PSQ-minor). Autonomic reactivity PRD was associated with R 2 ∗ measures in both regions. R 2 ∗ RN was related to PRD during heat stimulation, whereas R 2 ∗ PAG was related to PRD during heat and cold-water conditioning. QSM/ R 2 ∗ RN were further associated with mechanical pain threshold (MPT) and mechanical pain sensitivity (MPS). Group-level differences were, however, minimal between CP, migraine, and HV cohorts.
CONCLUSION: Modality-specific associations between iron-sensitive MRI measures and descending inhibition, nociceptive gain, and autonomic reactivity were observed. These findings indicate that QSM and R 2 ∗ mapping together capture individual variation in pain-modulatory physiology, supporting the concept of an iron-related biotype of pain modulation rather than a categorical marker. In contrast, regional iron content did not differentiate CP, M, and HV groups.
METHODS: Sixty participants (20 CP, 20 M, and 20 HV) underwent a 3T MRI examination. Pain modulatory and autonomic function was assessed using conditioned pain modulation (CPM) and pupil reflex dilation (PRD) across all participants (n = 60), whereas quantitative sensory testing (QST) and pain sensitivity questionnaire (PSQ) were assessed in CP and M only (n = 40). Group differences and iron-pain relationships were evaluated using ANOVA or Kruskal-Wallis tests and linear regression models.
RESULTS: Distinct region- and modality-specific relationships were observed between iron-sensitive MRI measures and pain-related outcomes. R 2 ∗ RN was associated with absolute and relative CPM effects. QSM PAG was associated with temporal summation and showed a trend-level association with subjective pain sensitivity (PSQ-minor). Autonomic reactivity PRD was associated with R 2 ∗ measures in both regions. R 2 ∗ RN was related to PRD during heat stimulation, whereas R 2 ∗ PAG was related to PRD during heat and cold-water conditioning. QSM/ R 2 ∗ RN were further associated with mechanical pain threshold (MPT) and mechanical pain sensitivity (MPS). Group-level differences were, however, minimal between CP, migraine, and HV cohorts.
CONCLUSION: Modality-specific associations between iron-sensitive MRI measures and descending inhibition, nociceptive gain, and autonomic reactivity were observed. These findings indicate that QSM and R 2 ∗ mapping together capture individual variation in pain-modulatory physiology, supporting the concept of an iron-related biotype of pain modulation rather than a categorical marker. In contrast, regional iron content did not differentiate CP, M, and HV groups.