Abstract
AbstractChronic inflammatory joint diseases (CIJD) have been linked to increased cardiovascular morbidity and mortality. A decisive reason could be a dysregulation of the autonomic nervous system (ANS), which is responsible for the control of cardio-vascular function. So far, the cause of changes in ANS functions remains elusive. In this study, we investigate the role of chronic pain and the insular cortex in autonomic control of cardiac functioning in patients with CIJD. We studied the sympathetic and parasympathetic branch of the ANS through the assessment of heart rate and heart rate variability (HRV) at rest and under cognitive stimulation. Furthermore, we investigated insular cortex volume by performing surface-based brain morphometry with FreeSurfer. For this study, 22 individual age- and sex-matched pairs for the magnetic resonance imaging analyses and 14 for the HRV analyses were recruited. Pain duration was negatively correlated with the resting heart rate in patients with chronic inflammatory joint diseases (n = 19). In a multiple linear regression model including only CIJD patients with HR at rest as a dependent variable, we found a significant positive relationship between HR at rest and the volume of the left insular cortex and a significant negative relationship between HR at rest and the volume of the right insular cortex. However, we found no significant differences in HRV parameters or insular cortex volumes between both groups. In this study we provide evidence to suggest insular cortex involvement in the process of ANS changes due to chronic pain in CIJD patients.
Publisher
Cold Spring Harbor Laboratory