Altered functional connectivity associated with time discounting in chronic pain

Area of Science:

• Neuroscience
• Behavioral Science
• Psychology

Background:

• Chronic pain (CP) is a global health issue often linked to unhealthy lifestyles.
• Time discounting (TD), valuing immediate rewards over future ones, indicates unhealthy behaviors.
• Overlapping neural mechanisms suggest a connection between CP and TD, but specific relationships remain unclear.

Purpose of the Study:

• To investigate the association between TD and behavioral measures in CP patients and healthy subjects.
• To examine the resting-state brain functional network related to TD in both groups.
• To elucidate the neural underpinnings of TD in the context of chronic pain.

Main Methods:

• Behavioral assessments of time discounting and meaningfulness.
• Resting-state functional magnetic resonance imaging (fMRI) to analyze brain functional networks.
• Comparison of TD associations and neural correlates between CP patients and healthy controls.

Main Results:

• Behaviorally, TD correlated with meaningfulness in healthy subjects, but with pain intensity in CP patients.
• In healthy subjects, TD was associated with a medial and dorsolateral prefrontal cortex (PFC) network within the default mode network (DMN).
• In CP patients, TD was linked to functional connectivity between the dorsolateral PFC (DLPFC) and temporal lobe, mediating the effect of pain intensity.

Conclusions:

• Time discounting in chronic pain patients is modulated by pain intensity.
• The neural network associated with TD shifts from medial to lateral frontal regions in CP patients.
• Understanding these neuro-behavioral links can inform interventions for chronic pain and related unhealthy behaviors.