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Somatotopically specific primary somatosensory connectivity to salience and default mode networks encodes clinical pain.
- Source :
-
Pain [Pain] 2019 Jul; Vol. 160 (7), pp. 1594-1605. - Publication Year :
- 2019
-
Abstract
- Although several studies have found that chronic pain is characterized by increased cross-network connectivity between salience network, sensorimotor network, and default mode network (DMN), a large sample-size investigation allowing for a more reliable evaluation of somatotopic specificity and subgroup analyses with linkage to clinical pain intensity has been lacking. We enrolled healthy adults and a large cohort of patients (N = 181) suffering from chronic low back pain (cLBP). To specifically link brain connectivity with clinical pain intensity, patients were scanned at baseline and after performing physical maneuvers that exacerbated pain. Compared with healthy adults, patients with cLBP demonstrated increased connectivity between the functionally localized back representation in the primary somatosensory cortex (S1back) and both salience network and DMN. Pain exacerbation maneuvers increased S1back connectivity to salience network regions, but decreased connectivity to DMN, with greater pain intensity increase associated with greater shifts in these connectivity patterns. Furthermore, only in patients with cLBP reporting high pain catastrophizing, DMN connectivity was increased to a cardinal node of the salience network, anterior insula cortex, which was correlated with increased postmaneuver pain in this cLBP subgroup. Hence, increased information transfer between salience processing regions, particularly anterior insula, and DMN may be strongly influenced by pain catastrophizing. Increased information transfer between the salience network and S1 likely plays an important role in shifting nociceptive afference away from self-referential processing, reallocating attentional focus, and affective coding of nociceptive afference from specific body areas. These results demonstrate S1 somatotopic specificity for cross-network connectivity in encoding clinical back pain and moderating influence of catastrophizing for DMN/insula connectivity.
- Subjects :
- Adult
Catastrophization psychology
Female
Healthy Volunteers
Humans
Low Back Pain diagnostic imaging
Low Back Pain psychology
Magnetic Resonance Imaging
Male
Middle Aged
Nerve Net diagnostic imaging
Neural Pathways diagnostic imaging
Neurons, Afferent
Nociception
Somatosensory Cortex diagnostic imaging
Low Back Pain physiopathology
Nerve Net physiopathology
Neural Pathways physiopathology
Somatosensory Cortex physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1872-6623
- Volume :
- 160
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Pain
- Publication Type :
- Academic Journal
- Accession number :
- 30839429
- Full Text :
- https://doi.org/10.1097/j.pain.0000000000001541