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Alteraciones de la microestructura de la sustancia blanca relacionadas con el estrés y dolor crónico
Yann Quidé1,2, Khaizuran Kamarul3, Sylvia M Gustin3,4
1NeuroRecovery Research Hub, School of Psychology, UNSW Sydney, Sydney, NSW, 2052, Australia. y.quide@unsw.edu.au.
Brain imaging and behavior
|February 7, 2026
Resumen
Los síntomas de estrés postraumático (TEPT) están relacionados con cambios en la sustancia blanca del uncinado en personas sanas, pero no en aquellas con dolor crónico. Esto sugiere mecanismos subyacentes diferentes para el TEPT en condiciones de dolor crónico.
Área de la Ciencia:
- Neuroimagen
- Psiquiatría
- Medicina del Dolor
Sus antecedentes:
- Los síntomas de estrés postraumático (TEPT) a menudo coexisten con el dolor crónico.
- Investigaciones previas indican alteraciones en la integridad de la sustancia blanca en el uncinado y el cíngulo en estudios separados de dolor crónico y TEPT.
- La relación específica entre el dolor crónico, el TEPT y la integridad de la sustancia blanca no se comprende completamente.
Objetivo del estudio:
- Investigar la asociación entre la gravedad de los síntomas de TEPT y la integridad microestructural de la sustancia blanca en personas con dolor crónico.
- Determinar si las diferencias en la integridad de la sustancia blanca en regiones cerebrales específicas son comunes en diversas afecciones de dolor crónico.
Principales métodos:
- Se utilizó imagen de difusión para evaluar la integridad de la sustancia blanca.
- Se extrajeron valores de anisotropía fraccional (FA) del uncinado y del cíngulo (porciones cingulada e hipocampal).
- Se realizaron regresiones lineales múltiples y análisis de moderación para examinar el grupo, la gravedad de los síntomas de TEPT y sus interacciones sobre los valores de FA.
Principales resultados:
- Se encontró una interacción significativa grupo-TEPT para la FA del uncinado.
- La mayor gravedad de los síntomas de TEPT se correlacionó con una menor FA del uncinado en los controles, pero no en el grupo de dolor crónico.
- No se observaron otras asociaciones significativas para las regiones del cíngulo.
Conclusiones:
- Los hallazgos sugieren que, si bien el TEPT se asocia con una menor FA del uncinado en personas sanas, esta relación no se mantiene en personas con dolor crónico.
- Factores neurobiológicos o psicológicos alternativos pueden influir en la integridad de la sustancia blanca en pacientes con dolor crónico que experimentan TEPT.
- Se necesita más investigación para explorar estos mecanismos alternativos, incluyendo posibles comorbilidades o efectos específicos del dolor.
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