Individually Unique Dynamics of Cortical Connectivity Reflect the Ongoing Intensity of Chronic Pain Article Swipe
Astrid Mayr
,
Pauline Jahn
,
Bettina Deak
,
Anne Stankewitz
,
Vasudev Devulapally
,
Viktor Witkovský
,
Olaf Dietrich
,
Enrico Schulz
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1101/2021.06.30.450553
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1101/2021.06.30.450553
Background Chronic pain diseases are characterised by an ongoing and fluctuating endogenous pain, yet it remains to be elucidated how this is reflected by the dynamics of ongoing functional cortical connections. The present study addresses this disparity by taking the individual perspective of pain patients into account, which is the varying intensity of endogenous pain. Methods To this end, we investigated the cortical encoding of 20 chronic back pain patients and 20 chronic migraineurs in four repeated fMRI sessions. During the recording, the patients were asked to continuously rate their pain intensity. A brain parcellation approach subdivided the whole brain into 408 regions. A 10 s sliding-window connectivity analysis computed the pair-wise and time-varying connectivity between all brain regions across the entire recording period. Linear mixed effects models were fitted for each pair of brain regions to explore the relationship between cortical connectivity and the observed trajectory of the patients’ fluctuating endogenous pain. Results Two pain processing entities were taken into account: pain intensity (high, middle, low pain) and the direction of pain intensity changes (rising vs. falling pain). Overall, we found that periods of high and increasing pain were predominantly related to low cortical connectivity. For chronic back pain this applies to the pain intensity-related connectivity for limbic and cingulate areas, and for the precuneus. The change of pain intensity was subserved by connections in left parietal opercular regions, right insular regions, as well as large parts of the parietal, cingular and motor cortices. The change of pain intensity direction in chronic migraine was reflected by decreasing connectivity between the anterior insular cortex and orbitofrontal areas, as well as between the PCC and frontal and ACC regions. Conclusions Interestingly, the group results were not mirrored by the individual patterns of pain-related connectivity, which is suggested to deny the idea of a common neuronal core problem for chronic pain diseases. In a similar vein, our findings are supported by the experience of clinicians, who encounter patients with a unique composition of characteristics: personality traits, various combinations of symptoms, and a wide range of individual responses to treatment. The diversity of the individual cortical signatures of chronic pain encoding results adds to the understanding of chronic pain as a complex and multifaceted disease. The present findings support recent developments for more personalised medicine.
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- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.1101/2021.06.30.450553
- https://www.biorxiv.org/content/biorxiv/early/2021/07/01/2021.06.30.450553.full.pdf
- OA Status
- green
- Cited By
- 3
- References
- 79
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3174517378
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Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3174517378Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1101/2021.06.30.450553Digital Object Identifier
- Title
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Individually Unique Dynamics of Cortical Connectivity Reflect the Ongoing Intensity of Chronic PainWork title
- Type
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preprintOpenAlex work type
- Language
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enPrimary language
- Publication year
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2021Year of publication
- Publication date
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2021-07-01Full publication date if available
- Authors
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Astrid Mayr, Pauline Jahn, Bettina Deak, Anne Stankewitz, Vasudev Devulapally, Viktor Witkovský, Olaf Dietrich, Enrico SchulzList of authors in order
- Landing page
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https://doi.org/10.1101/2021.06.30.450553Publisher landing page
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https://www.biorxiv.org/content/biorxiv/early/2021/07/01/2021.06.30.450553.full.pdfDirect link to full text PDF
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YesWhether a free full text is available
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greenOpen access status per OpenAlex
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https://www.biorxiv.org/content/biorxiv/early/2021/07/01/2021.06.30.450553.full.pdfDirect OA link when available
- Concepts
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Precuneus, Chronic pain, Intensity (physics), Psychology, Physical medicine and rehabilitation, Neuroscience, Medicine, Cognition, Physics, Quantum mechanicsTop concepts (fields/topics) attached by OpenAlex
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3Total citation count in OpenAlex
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10Other works algorithmically related by OpenAlex
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