Evidence map›Paper›PMID 40802103›Full record

ArticleRheumatology international2025

Brain compensation and volume alterations in patients with severe knee osteoarthritis: a cross-sectional neuroimaging study.

Fuad F Chaim, Marta Imamura, Tiffany M Chaim-Avancini, Claudia C Leite, Paula Squarzoni, Linamara R Battistella, Felipe Fregni

Abstract read
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Article in Rheumatology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Fuad F ChaimInstituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Sao Paulo, Brazil.ORCID http://orcid.org/0000-0003-1506-5416
Marta ImamuraInstituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Sao Paulo, Brazil. marta.imamura@fm.usp.br.ORCID http://orcid.org/0000-0003-0355-9697
Tiffany M Chaim-AvanciniLaboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Sao Paulo, Brazil.ORCID http://orcid.org/0000-0003-0798-3233
Claudia C LeiteFaculty of Medicine, Hospital das Clínicas HCFMUSP, Institute of Radiology, University of Sao Paulo, São Paulo, Brazil.ORCID http://orcid.org/0000-0002-1168-0780
Paula SquarzoniLaboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Sao Paulo, Brazil.ORCID http://orcid.org/0000-0002-5483-759X
Linamara R BattistellaInstituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Sao Paulo, Brazil.ORCID http://orcid.org/0000-0001-5275-0733
Felipe FregniDepartment of Physical Medicine and Rehabilitation, Massachusetts General Hospital and Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA. fregni.felipe@mgh.harvard.edu.ORCID http://orcid.org/0000-0003-1307-9355

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Osteoarthritis (OA) is the most prevalent joint disease worldwide and the leading cause of functional disability. Recent studies have shown alterations in gray matter (GM) volume in areas related to pain sensitivity and perception in patients experiencing chronic pain. These brain changes may be reversible once pain relief is obtained. This study aimed to compare brain volume measurements in patients with chronic pain due to knee OA with healthy controls using brain magnetic resonance imaging (MRI) and voxel-based morphometric (VBM) analysis. Additionally, we aimed to correlate these findings with motor functional capacity and stiffness data. We selected 29 adults with severe knee OA and 28 healthy controls, matched for age and gender. All participants underwent MRI, and the images were processed and analyzed using the VBM method with the SPM 8 program. Predefined brain areas, including the insula, prefrontal cortex, dorsolateral cortex, ventrolateral cortex, temporal cortex, parietal cortex, cingulate gyrus, and thalamus, were selected for comparative analysis. We observed a reduction in GM volume in patients with knee OA pain compared to healthy controls in several regions, including the right and left anterior cingulate gyrus, right amygdala, hippocampus, parahippocampal gyrus, left amygdala, hippocampus, parahippocampal gyrus, right precuneus, and right insula. Additionally, we observed an increase in GM volume in the right and left orbitofrontal cortex and right superior temporal cortex. Our results support the hypothesis that knee OA-related pain is associated with region-specific volumetric brain alterations. Importantly, the observed increases in orbitofrontal and temporal GM volume may reflect compensatory neuroplasticity in response to chronic pain burden. These findings align with emerging models of brain compensation. Understanding these patterns may facilitate the development of prognostic and surrogate biomarkers for chronic pain and inform brain-targeted rehabilitation strategies.

Indexed as

BrainChronic PainGray MatterKnee JointOsteoarthritis, KneeAgedCase-Control StudiesCross-Sectional StudiesFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedNeuroimagingOrgan SizeSeverity of Illness IndexChronic painImage processing, Computer-AssistedMagnetic resonance imagingNeuroimagingOsteoarthritis, kneePrecuneus

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.