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Precision Connectivity in Arthritis Pain with Permutation and Network Analysis: A Key Step Toward Clinical

Belfin Robinson¹, Emilio G Cediel¹, William Reuther¹

¹University of North Carolina at Chapel Hill.

Research Square

|September 15, 2025

Summary

Osteoarthritis pain disrupts brain connectivity, particularly in the thalamus, cingulate gyrus, and insula. These key hubs show altered sensory, emotional, and cognitive processing in patients with chronic pain.

Keywords:

chronic pain network analysis osteoarthritis permutation rs-fMRI seed analysis

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Area of Science:

Neuroscience
Medical Imaging
Radiology

Background:

Chronic pain, particularly osteoarthritis-related pain, significantly impacts quality of life.
Understanding the neural underpinnings of chronic pain is crucial for developing effective treatments.

Purpose of the Study:

To identify atypical neural connectivity in the brains of individuals with osteoarthritis-related chronic pain.
To compare brain connectivity patterns between osteoarthritis patients and healthy controls using resting-state functional magnetic resonance imaging (rs-fMRI).

Main Methods:

A seed-based connectivity analysis was performed using rs-fMRI data.
Regions of interest (ROIs) were derived from MNI and Automated Anatomical Labeling (AAL) atlases.
Connectivity matrices were compared between 56 osteoarthritis patients and 20 healthy controls using permutation tests, with network analysis to identify hub scores.

Main Results:

Significant atypical neural connections were found in the cingulate gyrus, insula, inferior parietal lobe, and thalamus of osteoarthritis patients.
The thalamus, cingulate gyrus, and insula were identified as key hubs in the chronic pain network.
Disrupted connectivity was also noted in the occipital lobe, temporal lobe, hippocampus, and basal ganglia, indicating altered sensory, emotional, and cognitive processing.

Conclusions:

Osteoarthritis-related chronic pain is associated with specific disruptions in brain neural connectivity.
The identified network hubs (thalamus, cingulate gyrus, insula) offer insights into the altered processing of pain.
These findings may guide the development of targeted interventions for osteoarthritis pain management.