Alteration in cerebral cortex thickness and structural covariance networks in patients with chronic...

Recent studies have reported regional brain structural alterations in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, patterns of cortical thickness (CT) changes and the topological organization of structural covariance networks (SCNs) in CP/CPPS remain insufficiently understood. This study aimed to investigate CT alterations and SCN organization in CP/CPPS using structural magnetic resonance imaging and graph theoretical analysis.

A total of 31 patients with CP/CPPS and 28 healthy controls (HCs) were included. All participants underwent three-dimensional T1-weighted magnetic resonance imaging. Cortical thickness was estimated based on the Destrieux atlas. CT-based SCNs were constructed using the Brain Connectivity Toolbox, and between-group differences in network topology were assessed using graph theoretical analysis.

Compared with HCs, patients with CP/CPPS exhibited regional cortical thickness alterations, including cortical thinning in the left planum temporale, left inferior frontal sulcus, left inferior part of the precentral sulcus, left subparietal sulcus, right lingual gyrus, right planum temporale, and right superior occipital sulcus and transverse occipital sulcus, as well as cortical thickening in the left superior frontal gyrus, left inferior temporal sulcus, and right short insular gyrus. Within patients, cortical thickness of the left subparietal sulcus was negatively correlated with PCS helplessness scores, whereas cortical thickness of the right short insular gyrus was positively correlated with NIH-CPSI quality of life impact scores. At the network level, CP/CPPS patients showed higher clustering coefficient (C_p), longer characteristic path length (L_p), and lower global efficiency (E_global), suggesting increased network segregation and reduced integration. No significant differences were observed in local network metrics after correction for multiple comparisons; however, exploratory analyses (p < 0.01, uncorrected) suggested increased nodal degree in the left middle frontal gyrus and decreased nodal metrics in occipital regions.

CP/CPPS may be associated with multi-level structural brain alterations, including regional cortical thickness changes and altered structural covariance network organization. These findings support the involvement of central nervous system structural abnormalities in CP/CPPS and provide preliminary insights into its neurobiological basis.