Pain-induced adaptations in the claustro-cingulate pathway

Persistent pain is a prevalent medical concern correlating with a hyperexcitable anterior cingulate cortex (ACC). Its activity is modulated by inputs from several brain regions, but the maladjustments that these afferent circuits undergo during the transition from acute to chronic pain still require clarification. We focus on ACC-projecting claustrum (CLA_ACC) neurons and their responses to sensory and aversive stimuli in a mouse model of inflammatory pain. Using chemogenetics, in vivo calcium imaging, and ex vivo electrophysiological approaches, we reveal that suppression of CLA_ACC activity acutely attenuates allodynia and that the claustrum preferentially transmits aversive information to the ACC. With prolonged pain, a claustro-cingulate functional impairment develops, which is mediated by a weakened excitatory drive onto ACC pyramidal neurons, resulting in a diminished claustral influence on the ACC. These findings support an instrumental role of the claustrum in the processing of nociceptive information and its susceptibility to persistent pain states.