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Chronic widespread pain patients show disrupted cortical connectivity in default mode and salience networks, modulated by pain sensitivity

Journal article
Authors H. Van Ettinger-Veenstra
P. Lundberg
P. Alföldi
M. Södermark
T. Graven-Nielsen
Anna Sjörs
M. Engström
B. Gerdle
Published in Journal of Pain Research
Volume 12
Pages 1743-1755
ISSN 1178-7090
Publication year 2019
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Pages 1743-1755
Language en
Keywords Default node network, DMN, FMRI, Functional connectivity, Functional magnetic resonance imaging, Salience network
Subject categories Neurosciences


Purpose: The remodeling of functional neuronal connectivity in chronic widespread pain (CWP) patients remains largely unexplored. This study aimed to investigate functional connectivity in CWP patients in brain networks related to chronic pain for changes related to pain sensitivity, psychological strain, and experienced pain. Patients and methods: Functional connectivity strength of the default mode network (DMN) and the salience network (SN) was assessed with functional magnetic resonance imaging. Between-group differences were investigated with an independent component analysis for altered connectivity within the whole DMN and SN. Then, changes in connectivity between nodes of the DMN and SN were investigated with the use of a seed-target analysis in relation to the covariates clinical pain intensity, pressure pain sensitivity, psychological strain, and as an effect of experienced experimental cuff-pressure pain. Results: CWP patients showed decreased connectivity in the inferior posterior cingulate cortex (PCC) in the DMN and increased connectivity in the left anterior insula/superior temporal gyrus in the SN when compared to controls. Moreover, higher pain sensitivity in CWP when compared to controls was related to increased connectivity within the SN (between left and right insula) and between SN and DMN (between right insula and left lateral parietal cortex). Conclusion: This study shows that connectivity within the DMN was decreased and connectivity within the SN was increased for CWP. Furthermore, we present a novel finding of interaction of pain sensitivity with SN and DMN-SN functional connectivity in CWP. © 2019 van Ettinger-Veenstra et al.

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