ArticleJournal of pain research2026
Altered Cortical Structure in Primary Dysmenorrhea: Cortical Thickness Mediates the Association Between Estradiol and Pain Catastrophizing.
Article in Journal of pain research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Primary dysmenorrhea (PDM), as a form of chronic pelvic pain, has a complex pathophysiology involving hormonal factors, central nervous system alterations, and maladaptive pain cognition. Previous neuroimaging studies have demonstrated structural brain alterations in patients with PDM. However, the relationships among hormone levels, brain structural changes, and pain catastrophizing remain poorly understood. This study aimed to investigate brain structural alterations and their associations with estradiol (E Methods: T1-weighted MRI scans and E Results: The PDM group scored significantly higher on the MPQ and PCS, suggesting greater pain perception and psychologic distress. Patients with PDM exhibited alterations in cortical thickness, volume, and folding within specific brain regions. Notably, the cingulate cortex, orbitofrontal cortex, and postcentral gyrus demonstrated substantial changes. Mediation analysis revealed that E Conclusion: This study identified brain structural alterations during the menstrual phase in patients with PDM and further found that cortical thickness of the right postcentral gyrus mediated the relationship between estradiol levels and pain magnification. These findings provide new insights into the complex mechanisms underlying PDM.
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