Alterations in Functional Connectivity Density in Patients With Phantom Limb Pain

Area of Science:

• Neuroscience
• Pain Research
• Medical Imaging

Background:

• Phantom limb pain (PLP) is a common and difficult condition for amputees.
• Its underlying mechanisms, likely involving maladaptive cortical reorganization, are not fully understood.

Purpose of the Study:

• To investigate cortical remodeling patterns in PLP patients.
• To identify specific brain regions and neural circuits linked to PLP.

Main Methods:

• Resting-state functional magnetic resonance imaging (rs-fMRI) was used.
• Functional connectivity density (FCD) mapping and voxel-wise functional connectivity (FC) analyses were performed on 18 PLP patients and 20 healthy controls.

Main Results:

• PLP patients exhibited altered FCD in sensorimotor, pain, and visual networks.
• The precentral gyrus (PreCG), insula (INS), precuneus (PCUN), and middle occipital gyrus (MOG) were key hubs correlated with pain severity (VAS).
• Decreased FC was found between these hubs and widespread brain areas, with increased FC noted in dorsolateral prefrontal cortex (DLPFC) subregions.

Conclusions:

• Novel insights into PLP neural mechanisms were revealed.
• Specific pathways (SFGdor-INS, MFG-PCUN) showed negative correlation with pain, suggesting crucial roles.
• These findings highlight potential targets for neuromodulation therapies for PLP.