Beyond Feeling: Chronic Pain Hurts the Brain, Disrupting the Default-Mode Network Dynamics

By Marwan N. Baliki, Paul Geha, Apkar Vania Apkarian, Dante R. Chialvo. Journal of Neuroscience, 2008

821 citations recorded by the source corpus.

Chronic pain patients suffer from more than just pain; depression and anxiety, sleep disturbances, and decision-making abnormalities (Apkarian et al., 2004a) also significantly diminish their quality of life. Recent studies have demonstrated that chronic pain harms cortical areas unrelated to pain (Apkarian et al., 2004b; Acerra and Moseley, 2005), but whether these structural impairments and behavioral deficits are connected by a single mechanism is as of yet unknown. Here we propose that long-term pain alters the functional connectivity of cortical regions known to be active at rest, i.e., the components of the “default mode network” (DMN). This DMN (Raichle et al., 2001; Greicius et al., 2003; Vincent et al., 2007) is marked by balanced positive and negative correlations between activity in component brain regions. In several disorders, however this balance is disrupted (Fox and Raichle, 2007). Using well validated functional magnetic resonance imaging (fMRI) paradigms to study the DMN (Fox et al., 2005), we investigated whether the impairments of chronic pain patients could be rooted in disturbed DMN dynamics. Studying with fMRI a group of chronic back pain (CBP) patients and healthy controls while executing a simple visual attention task, we discovered that CBP patients, despite performing the task equally well as controls, displayed reduced deactivation in several key DMN regions. These findings demonstrate that chronic pain has a widespread impact on overall brain function, and suggest that disruptions of the DMN may underlie the cognitive and behavioral impairments accompanying chronic pain.

Subfields: Cardiology and Cardiovascular Medicine, Cognitive Neuroscience

View Paper: https://www.semanticscholar.org/paper/4881d40ee7e4e35c486cdfa8b475cdd4ba532e58

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Citations in the corpus

Resting state functional connectivity in addiction: Lessons learned and a road ahead (2012, background): “chronic pain (Baliki et al., 2008; Tagliazucchi et al., 2010), depression”
Pain and the brain: Specificity and plasticity of the brain in clinical chronic pain (2010, background): “On the other hand, decreased activity was significantly different [10].”
Default-mode brain dysfunction in mental disorders: a systematic review. (2009, background): “…in the context of multiple rosis (Lowe et al., 2002), Parkinson’s disease (Tinaz et al., 2008), ile X syndrome (Menon et al., 2004), hepatic cirrhosis (Zhang l., 2007), and chronic pain (Baliki et al., 2008) was not ase cite this article in press as: Broyd, S.J., et al., Default-mode bra behav.”
Towards a theory of chronic pain (2008, neutral): “We recently demonstrated the impact of chronic pain on resting state brain activity (Baliki et al., 2008b).”