Neuroanatomical Substrates of Chronic Pain in Sickle Cell Disease: A Voxel-Based Morphometry and Resting-State fMRI Study in Nigerian Adults

Sickle cell disease is among the most prevalent genetic disorders in Nigeria and is characterised by recurrent vaso-occlusive crises and chronic pain that significantly impair quality of life. Recent evidence from non-African populations suggests that chronic pain in sickle cell disease is associated with central sensitisation and neuroanatomical changes in pain-processing regions, including the anterior cingulate cortex, insula, and periaqueductal grey. The neuroanatomical basis of chronic pain in Nigerian sickle cell disease patients has not been examined. This study aims to characterise grey matter volume differences and resting-state functional connectivity changes in pain-processing brain regions in adults with sickle cell disease and chronic pain compared with sickle cell disease patients without chronic pain and healthy haemoglobin-AA controls at the Lagos State University Teaching Hospital. Voxel-based morphometry on three-dimensional T1-weighted MRI will identify regional grey matter volume differences. Resting-state functional MRI will characterise connectivity within the descending pain modulation network and default mode network. Pain burden will be quantified using validated chronic pain indices. Findings will provide the first neuroanatomical evidence base for central sensitisation in Nigerian sickle cell disease patients, advancing the understanding of sickle cell pain neuroscience and informing the design of neurologically targeted pain management strategies.

Keywords: sickle cell disease, chronic pain, neuroimaging, voxel-based morphometry, central sensitisation