# Regional homogeneity alterations reflect pain and emotional dysregulation in adenomyosis

## TL;DR

The study finds that brain activity changes in specific regions are linked to pain and emotional issues in women with adenomyosis.

## Contribution

This study identifies specific brain regions with altered regional homogeneity in adenomyosis patients, linking them to pain severity and emotional dysregulation.

## Key findings

- AMD patients showed increased regional homogeneity in the right fusiform gyrus and decreased in bilateral supramarginal gyri.
- Abnormal brain activity in the right fusiform gyrus correlated with higher pain severity and anxiety scores.
- Regions like the right hippocampus and cerebellum were also associated with anxiety and depression symptoms.

## Abstract

Adenomyosis (AM) with dysmenorrhea (AMD) is a global public health concern that may involve abnormal brain function and heightened vulnerability to anxiety and depression. This study aimed to investigate static and dynamic regional homogeneity (sReHo and dReHo) alterations in AMD and their associations with clinical symptoms.

Fifty-two patients with AMD and 52 age- and education-matched healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (rs-MRI). sReHo and dReHo maps were generated and compared using two-sample t-tests (voxel-level p < 0.01; cluster-level, Gaussian random field corrected p < 0.05), with age, education and head motion as covariates. Effect sizes (Cohen’s d) were calculated for significant clusters. Partial correlation analyses assessed relationships between regional homogeneity (ReHo) alterations and clinical measures, controlling for medication use, menstrual phase and psychiatric history.

Compared with HCs, AMD patients showed significantly increased sReHo and dReHo in the right fusiform gyrus (FFG; d = 0.84, p < 0.001) and decreased values in the bilateral supramarginal gyri (SMG; d = −0.73, p < 0.001). Additional regiongs exhibiting abnormal dReHo were included the bilateral angular gyri, right hippocampus, right cerebellum (lobule 4_5) , left middle frontal gyrus (MFG) and multiple subdivisions of the inferior frontal gyrus. Importantly, ReHo in the right FFG positively correlated with pain severity (visual analogue scale (VAS): r = 0.539-0.797, p < 0.001) and anxiety (Hamilton Anxiety Scale (HAMA): r = 0.442, p = 0.001). Abnormalities in the right hippocampus and cerebellum were also significantly associated with anxiety and depression scores (r = 0.555–0.861, all p < 0.001).

AMD is characterized by altered intrinsic brain activity in pain- and emotion-related regions, supporting a central mechanism underlying chronic pain and affective symptoms. These findings provide neuroimaging evidence for AMD-related brain dysfunction. Longitudinal studies with larger cohorts and hormonal control are warranted to confirm these results and clarify causal relationships.