Abstract
The degree and salience of pain have been known to be constantly monitored and modulated by the brain. In the case of maladaptive neural responses as reported in centralized pain conditions such as complex regional pain syndrome (CRPS), the perception of pain is amplified and remains elevated even without sustained peripheral pain inputs. Given that the attentional state of the brain greatly influences the perception and interpretation of pain, we investigated the role of the attention network and its dynamic interactions with other pain-related networks of the brain in CRPS. We examined alterations in the intra- and inter-network functional connectivities in 21 individuals with CRPS and 49 controls. CRPS-related reduction in intra-network functional connectivity was found in the attention network. Individuals with CRPS had greater inter-network connectivities between the attention and salience networks as compared with healthy controls. Furthermore, individuals within the CRPS group with high levels of pain catastrophizing showed greater inter-network connectivities between the attention and salience networks. Taken together, the current findings suggest that these altered connectivities may be potentially associated with the maladaptive pain coping as found in CRPS patients.
Highlights
Chronic pain is one of the major public health problems due to its debilitating effects on quality of life and function[1,2,3]
Functional coupling between the attention and salience networks was enhanced in individuals with complex regional pain syndrome (CRPS) relative to healthy individuals (permutation adjusted P = 0.02, effect size (ES) = 0.63, Fig. 2a)
The current study provides one of the first evidence of the role of the attention network and its dynamic interactions with other pain-related resting-state networks (RSNs) in the case of CRPS
Summary
Chronic pain is one of the major public health problems due to its debilitating effects on quality of life and function[1,2,3]. Central sensitization or centralization of pain, a condition of increased neural signaling in the central nervous system that generates hypersensitivity to pain[5], may be linked to structural or functional changes in the brain[6,7,8] This condition has been suggested to play a role in the pathophysiological mechanisms underlying chronic pain[5,9,10]. The salience network of the brain has received considerable interest in research regarding centralized pain, due to its activation when attending to painful stimuli[12] Studies have reported both functional and structural abnormalities of the salience network in individuals with centralized pain conditions[11,18,19,20]. We investigated possible alterations of inter-network functional connectivities between the attention network and other pain-related RSNs in individuals with CRPS, as well as its relationship with the level of pain catastrophizing, using the Pain Catastrophizing Scale (PCS)[27]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
