Sustained perturbation in functional connectivity induced by cold pain.
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Authors
Makovac, Elena
Dipasquale, Ottavia
Medina, Sonia
O'Daly, Owen
O'Muircheartaigh, Jonathan
de Lara Rubio, Alfonso
Williams, Steven CR
McMahon, Stephen B
Howard, Matthew A
Publication Date
2020-10Journal Title
European Journal of Pain
ISSN
1090-3801
Publisher
Elsevier
Volume
24
Issue
9
Pages
1850-1861
Language
eng
Type
Article
This Version
VoR
Metadata
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Makovac, E., Dipasquale, O., Jackson, J., Medina, S., O'Daly, O., O'Muircheartaigh, J., de Lara Rubio, A., et al. (2020). Sustained perturbation in functional connectivity induced by cold pain.. European Journal of Pain, 24 (9), 1850-1861. https://doi.org/10.1002/ejp.1633
Abstract
BACKGROUND: Functional connectivity (FC) perturbations have been reported in multiple chronic pain phenotypes, but the nature of reported changes varies between cohorts and may relate to the consequences of living with chronic-pain related comorbidities, such as anxiety and depression. Healthy volunteer studies provide opportunities to study the effects of tonic noxious stimulation independently of these sequelae. Connectivity changes in task negative and positive networks, for example, the default mode and salience networks (DMN/SN), respectively, have been described, but how these and other connectivity networks, for example, those governing descending pain control are affected by the presence of tonic, noxious stimulation in healthy, pain-free individuals, remains unknown. METHOD: In 20 healthy volunteers, we assessed FC prior to, during, and following tonic cold painful stimulation in the ventromedial prefrontal cortex (vmPFC), rostral anterior insula (rAI), subgenual anterior cingulate cortex (ACC) and periaqueductal grey (PAG). We also recorded subjectively reported pain using a computerised visual analogue scale. RESULTS: We saw DMN FC changes during painful stimulation and that inter-network connectivity between the rAI with the vmPFC increased during pain, whereas PAG-precuneus FC decreased. Pain-induced FC alterations persisted following noxious stimulation. FC changes related to the magnitude of individuals' subjectively reported pain. CONCLUSIONS: We demonstrate FC changes during and following tonic cold-pain in healthy participants. Similarities between our findings and reports of patients with chronic pain suggest that some FC changes observed in these patients may relate to the presence of an ongoing afferent nociceptive drive. SIGNIFICANCE: How pain-related resting state networks are affected by tonic cold-pain remains unknown. We investigated functional connectivity alterations during and following tonic cold pain in healthy volunteers. Cold pain perturbed the functional connectivity of the ventro-medial prefrontal cortex, anterior insula, and the periacquaductal grey area. These connectivity changes were associated with the magnitude of individuals' reported pain. We suggest that some connectivity changes described in chronic pain patients may be due to an ongoing afferent peripheral drive.
Keywords
Brain Mapping, Chronic Pain, Humans, Magnetic Resonance Imaging, Neural Pathways, Prefrontal Cortex
Sponsorship
This work was funded by a Medical
Research Council Experimental Medicine
Challenge Grant (MR/N026969/1). MAH,
SM, OO and SW are also supported by
the NIHR Biomedical Research Centre for
Mental Health at the South London and
Maudsley NHS Trust. JOM is supported
by a Sir Henry Dale Fellowship jointly
funded by the Welcome Trust and the Royal
Society (grant number 206675/Z/17/Z) and
a Medical Research Council (MRC) Centre
grant (MR/N026063/1).
Identifiers
External DOI: https://doi.org/10.1002/ejp.1633
This record's URL: https://www.repository.cam.ac.uk/handle/1810/330559
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