PMID- 30839429 OWN - NLM STAT- MEDLINE DCOM- 20200520 LR - 20221005 IS - 1872-6623 (Electronic) IS - 0304-3959 (Print) IS - 0304-3959 (Linking) VI - 160 IP - 7 DP - 2019 Jul TI - Somatotopically specific primary somatosensory connectivity to salience and default mode networks encodes clinical pain. PG - 1594-1605 LID - 10.1097/j.pain.0000000000001541 [doi] AB - 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. FAU - Kim, Jieun AU - Kim J AD - Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States. AD - Division of Clinical Research, Korea Institute of Oriental Medicine, Daejeon, Korea. FAU - Mawla, Ishtiaq AU - Mawla I AD - Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States. FAU - Kong, Jian AU - Kong J AD - Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States. AD - Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States. FAU - Lee, Jeungchan AU - Lee J AD - Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States. FAU - Gerber, Jessica AU - Gerber J AD - Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States. FAU - Ortiz, Ana AU - Ortiz A AD - Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States. FAU - Kim, Hyungjun AU - Kim H AD - Division of Clinical Research, Korea Institute of Oriental Medicine, Daejeon, Korea. FAU - Chan, Suk-Tak AU - Chan ST AD - Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States. FAU - Loggia, Marco L AU - Loggia ML AD - Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States. FAU - Wasan, Ajay D AU - Wasan AD AD - Department of Anesthesiology, Center for Pain Research, University of Pittsburgh, Pittsburgh, PA, United States. FAU - Edwards, Robert R AU - Edwards RR AD - Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States. FAU - Gollub, Randy L AU - Gollub RL AD - Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States. AD - Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States. FAU - Rosen, Bruce R AU - Rosen BR AD - Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States. FAU - Napadow, Vitaly AU - Napadow V AD - Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States. AD - Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States. LA - eng GR - R01 AR064367/AR/NIAMS NIH HHS/United States GR - S10 RR021110/RR/NCRR NIH HHS/United States GR - P41 RR014075/RR/NCRR NIH HHS/United States GR - P01 AT009965/AT/NCCIH NIH HHS/United States GR - R01 AT007550/AT/NCCIH NIH HHS/United States GR - P01 AT006663/AT/NCCIH NIH HHS/United States GR - S10 RR023043/RR/NCRR NIH HHS/United States GR - R61 AT009306/AT/NCCIH NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PL - United States TA - Pain JT - Pain JID - 7508686 SB - IM MH - Adult MH - Catastrophization/psychology MH - Female MH - Healthy Volunteers MH - Humans MH - Low Back Pain/diagnostic imaging/*physiopathology/psychology MH - Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Nerve Net/diagnostic imaging/*physiopathology MH - Neural Pathways/diagnostic imaging/*physiopathology MH - Neurons, Afferent MH - Nociception MH - Somatosensory Cortex/diagnostic imaging/*physiopathology PMC - PMC6586503 MID - NIHMS1522557 COIS- Competing interests The authors declare no competing interests. EDAT- 2019/03/07 06:00 MHDA- 2020/05/21 06:00 PMCR- 2020/07/01 CRDT- 2019/03/07 06:00 PHST- 2019/03/07 06:00 [pubmed] PHST- 2020/05/21 06:00 [medline] PHST- 2019/03/07 06:00 [entrez] PHST- 2020/07/01 00:00 [pmc-release] AID - 00006396-201907000-00013 [pii] AID - 10.1097/j.pain.0000000000001541 [doi] PST - ppublish SO - Pain. 2019 Jul;160(7):1594-1605. doi: 10.1097/j.pain.0000000000001541.