Background & Aims

Research has indicated that the default mode network (DMN) is perturbated in patients with chronic pain when compared to healthy controls (Baliki et al., 2008), and this perturbation is correlated with the duration of pain during the chronic pain stage (Baliki et al., 2014). It remains unclear whether DMN adaptations manifest during the subacute pain stage and progress over time due to the duration of pain experience, rather than being a specific correlate of the chronic pain stage. Furthermore, information regarding whether these adaptations are related to cognitive processes of adaptation is lacking.

Methods

To this end, we examined the DMN in 31 patients with chronic back pain (CBP), 77 patients with subacute back pain (SBP) as well as 39 healthy pain-free controls (HC) applying a graph-theoretic network approach on functional resting-state magnetic resonance imaging. Beyond the comparison between groups, we used a linear analysis considering the years lived with pain (YLP) across all back pain patients and additionally performed a mediation analysis of the role of cognitive pain coping.

Results

In line with previous studies, we found significant DMN perturbation in CBP compared to HC. However, this did not apply to the comparison of CBP to SBP. Instead, we observed a positive correlation between DMN perturbation and YLP. This was significantly mediated by coping attitudes towards pain.

Conclusions

DMN perturbation may thus reflect neural adaptation processes to pain experience rather than a single correlate of the chronic pain stage and be modulated by cognitive adaption. This points to potentially under-investigated significant adaptation processes that could enable more fine-grained patient stratification.

References

Baliki, M. N., Geha, P. Y., Apkarian, A. V., & Chialvo, D. R. (2008). Beyond feeling: Chronic pain hurts the brain, disrupting the default-mode network dynamics. The Journal of neuroscience?: the official journal of the Society for Neuroscience, 28(6), 1398–1403. https://doi.org/10.1523/JNEUROSCI.4123-07.2008
Baliki, M. N., Mansour, A., Ali Mansour, Alex T. Baria, Baria, A. T., & Apkarian, A. V. (2014). Functional reorganization of the default mode network across chronic pain conditions. PLOS ONE, 9(9). https://doi.org/10.1371/journal.pone.0106133

Presenting Author

Nils Jannik Heukamp

Poster Authors

Nils Jannik Heukamp

MSc

University Medical Center Kiel

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Vera Moliadze PhD

Institute of Medical Psychology and Medical Sociology, University Medical Centre Schleswig-Holstein,

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Mina Kandi?

Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Facult

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Katrin Usai PhD

Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Facult

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Martin Löffler

Clinical Psychology, Department of Experimental Psychology, Heinrich Heine University Düsseldorf

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Herta Flor

Interdisciplinary Center for Clinical Trials, Johannes Gutenberg University Medical Center Mainz

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Frauke Nees

University Medical Center Schleswig-Holstein, Kiel University

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Topics

  • Pain Imaging