A corticospinal signature for interindividual pain sensitivity

Area of Science:

• Neuroscience
• Pain research
• Neuroimaging

Background:

• Conventional pain models focus on the brain, neglecting the spinal cord's role in pain processing.
• Individual pain sensitivity varies significantly, necessitating better predictive biomarkers.

Purpose of the Study:

• To identify and validate a corticospinal pain sensitivity signature.
• To investigate the causal relationship between corticospinal connectivity and pain perception.
• To develop a biomarker bridging laboratory pain measures and clinical symptoms.

Main Methods:

• Simultaneous corticospinal magnetic resonance imaging (cs-fMRI) to capture functional connectivity.
• Machine learning models trained on resting-state data from healthy individuals.
• Validation across independent healthy and patient cohorts.
• Transcranial magnetic stimulation (TMS) for causal inference.

Main Results:

• A corticospinal pain sensitivity signature accurately predicts individual pain sensitivity and clinical pain.
• The model generalized across diverse datasets and outperformed purely brain-centric models.
• Enhanced motor cortex-spinal connectivity was causally linked to altered pain perception (r=0.55).

Conclusions:

• A novel corticospinal biomarker for pain sensitivity has been identified.
• This signature offers insights into pain mechanisms and translation from healthy to clinical populations.
• Findings inform the development of targeted neuromodulation strategies for pain management.