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1 Dept. of Biomedical Sciences, University of Maryland Dental School, Baltimore, Maryland, United States; Program in Neuroscience, University of Maryland, Baltimore, Maryland, United States
2 Dept. of Biomedical Sciences, University of Maryland Dental School, Baltimore, Maryland, United States; Research Center for Neuroendocrine Influences on Pain, University of Maryland, Baltimore, Maryland, United States
3 Dept. of Diagnostic Radiology, University of Maryland, Baltimore, Maryland, United States; University of Maryland Program in Neuroscience, Baltimore, Maryland, United States
4 Dept. of Statistics, Iowa State University, Ames, Iowa, United States
5 Dept. of Biomedical Sciences, University of Maryland Dental School, Baltimore, Maryland, United States; Research Center for Neuroendocrine Influences on Pain, University of Maryland, Baltimore, Maryland, United States; Program in Neuroscience, University of Maryland, Baltimore, Maryland, United States
* To whom correspondence should be addressed. E-mail: jgreenspan{at}umaryland.edu.
There are limited data addressing the question of sex differences in pain-related cerebral processing. This study examined whether pain-related BOLD signal change measured with fMRI demonstrated sex differences, under conditions of equivalent pain perception. Twenty-eight healthy volunteers (17 female) were subject to a fMRI scan while noxious heat stimuli were applied to the left foot dorsum. Significant BOLD signal modulation was observed in several nociceptive-processing regions of interest (ROIs) in all subjects. There were no sex differences in the spatial extent of BOLD signal change for any ROI, but the signal amplitude was lower for women in most ROIs, and significantly so for the primary somatosensory cortex (S1), the mid-anterior cingulate cortex (mid-ACC), and the dorsolateral prefrontal cortex (DLPFC). The BOLD signal response could be positive or negative, and frequently both polarities were observed within a single ROI. In most ROIs, women show proportionately more voxels with negative signal change than men, and this difference was statistically significant for the primary somatosensory cortex (S1) and the dorsolateral prefrontal cortex (DLPFC). The time course of the negative signal change was very similar to that of the positive signal change, suggesting that the latter was not "driving" the former. The location of negative and positive clusters formed distinct patterns in several of the ROIs, and these patterns suggest something other than a local "steal" phenomenon as an explanation for the negative signal changes. Sex differences in baseline cerebral blood flow may contribute to the BOLD signal differences observed in this study.
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