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Author Spotlight: Quantifying Pain Experience – An Illustrative Approach Using the Pain Body Diagram
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Dynamic pain connectome functional connectivity and oscillations reflect multiple sclerosis pain
Rachael L Bosma1, Junseok A Kim1,2, Joshua C Cheng1,2
1Division of Brain, Imaging, and Behaviour-Systems Neuroscience, Krembil Brain Institute, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
Pain
|July 12, 2018
Summary
Multiple sclerosis pain involves abnormal brain network connections. Specific changes in the salience network and default mode network relate to neuropathic pain and its interference in patients.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Pain is a common and disabling symptom in multiple sclerosis (MS).
- The underlying mechanisms of MS pain remain poorly understood.
- Previous research indicates altered functional connectivity in chronic pain conditions, particularly involving the salience network (SN) and default mode network (DMN).
Purpose of the Study:
- To investigate abnormalities in functional connectivity (FC) and brain signal variability in patients with MS.
- To test the hypothesis of abnormal DMN-SN cross-network static FC (sFC), dynamic FC (dFC) in SN-pathway connections, and disrupted BOLD variability in the pain connectome.
- To explore the relationship between these neuroimaging findings and neuropathic pain (NP) features and pain interference.
Main Methods:
- Resting-state functional magnetic resonance imaging (fMRI) was used in 31 MS patients and 31 controls.
- Measures included sFC, dFC, and regional BOLD variability within the dynamic pain connectome.
- Questionnaires assessed pain characteristics and pain interference.
Main Results:
- Approximately 50% of MS patients exhibited features of NP.
- Abnormalities in SN-DMN sFC were primarily observed in the mixed-neuropathic subgroup.
- Patients with mixed NP showed significant dFC alterations in SN engagement with ascending and descending pathways.
- Increased BOLD variability was noted in the DMN.
- The extent of sFC and BOLD variability abnormalities correlated with pain interference levels.
Conclusions:
- Altered SN-DMN cross-network functional connectivity and temporal dynamics are associated with MS pain.
- These neuroimaging findings may serve as biomarkers for MS pain and its impact.
- The study highlights the complex neural underpinnings of pain in multiple sclerosis.
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