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Updated: Apr 28, 2026
Author Spotlight: Methodologies and Advancements of Chronic Pain Management Research
Published on: January 5, 2024
Gray matter alterations in chronic pain: A network-oriented meta-analytic approach
Franco Cauda1, Sara Palermo2, Tommaso Costa1
1GCS fMRI, Koelliker Hospital, Department of Psychology, University of Turin, Turin, Italy ; Functional Neuroimaging and Complex Systems Group, Department of Psychology, University of Turin, Turin, Italy ; Department of Psychology, University of Turin, Turin, Italy.
Chronic pain causes widespread gray matter changes in the brain, affecting specific networks differently based on the pain type. These findings highlight the importance of a network-based approach for understanding chronic pain.
Area of Science:
- Neuroscience
- Medical Imaging
- Pain Research
Background:
- Chronic pain is associated with gray matter modifications, but the direction and extent of these changes remain debated.
- Existing research often overlooks the network-level impact of chronic pain and the influence of comorbidities.
Purpose of the Study:
- To employ a novel network-oriented meta-analytic approach to characterize morphological brain changes in chronic pain.
- To investigate common and specific network alterations across different chronic pain pathologies.
- To determine if chronic pain selectively targets specific large-scale brain networks.
Main Methods:
- Utilized network decomposition, representational similarity analysis, and model-based clustering.
- Identified a core set of commonly altered brain areas and their network involvement.
- Examined pathology-specific alterations and relationships between altered networks.
Main Results:
- Chronic pain induces both common and pathology-specific gray matter alterations within large-scale brain networks.
- Common alterations observed in prefrontal regions, anterior insula, cingulate cortex, basal ganglia, thalamus, and other key areas.
- Salience and attentional networks show similar targeting across pain types, while sensorimotor and attention circuits are differentially affected.
Conclusions:
- Chronic pain selectively targets specific large-scale brain networks, similar to some neurodegenerative diseases.
- Findings support a network-based perspective for understanding and studying chronic pain.
- The study provides a comprehensive characterization of morphological brain changes associated with chronic pain.
