ArticleBrain imaging and behavior2026
Altered hippocampal subfield functional connectivity and its association with back pain in axial spondyloarthritis: a multimodal neuroimaging study.
Article in Brain imaging and behavior, 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
To investigate hippocampal subfield volumes and resting-state functional connectivity (rsFC) in patients with axial spondyloarthritis (axSpA), and to assess their clinical relevance. In this cross-sectional study, 39 patients with axSpA and 41 healthy controls (HCs) underwent 3-T structural T1-weighted and resting-state functional MRI. Hippocampal subfields were segmented using FreeSurfer, and seed-based rsFC maps were computed for 12 subfields per hemisphere. Group differences were assessed with general linear models (FDR-corrected) for volumes and permutation-based family-wise error correction with threshold-free cluster enhancement for rsFC. Partial correlations adjusted for age, sex, and education tested associations between rsFC and clinical parameters (FDR-corrected). No hippocampal subfield volume differed significantly between groups after FDR correction, although patients with axSpA showed nominally larger right CA4 and bilateral GC-ML-DG volumes. Increased rsFC between the left presubiculum and left precentral gyrus/supplementary motor area (PreCG/SMA) was observed in patients relative to HCs (permutation-based FWER-corrected p < 0.05). Presubiculum-PreCG/SMA rsFC was negatively associated with overall back pain (partial r = -0.52, p = 0.001, FDR-corrected q = 0.028), the only association surviving FDR correction across all clinical parameters. No significant associations were observed with inflammatory markers or disease activity indices. axSpA is associated with hippocampal-motor cortical connectivity, with increased presubiculum-PreCG/SMA rsFC linked to lower back pain severity, whereas hippocampal subfield volumes are largely preserved. These findings support reconceptualizing axSpA as a systemic disease with measurable central nervous system involvement and pain-related network reorganization. Clinical trials register number: ChiCTR2500111024 (October 23th 2025).
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