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Brief Communications Beyond Feeling: Chronic Pain Hurts the Brain, Disrupting

Summary: Brief Communications
Beyond Feeling: Chronic Pain Hurts the Brain, Disrupting
the Default-Mode Network Dynamics
Marwan N. Baliki,1 Paul Y. Geha,1 A. Vania Apkarian,1,2,3,4 and Dante R. Chialvo1
Departments of 1Physiology, 2Anesthesia, and 3Surgery, and 4Lurie Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago,
Illinois 60611
Chronic pain patients suffer from more than just pain; depression and anxiety, sleep disturbances, and decision-making abnormalities
areas unrelated to pain (Apkarian et al., 2004b; Acerra and Moseley, 2005), but whether these structural impairments and behavioral
of cortical regions known to be active at rest, i.e., the components of the "default mode network" (DMN). This DMN (Raichle et al., 2001;
Greicius et al., 2003; Vincent et al., 2007) is marked by balanced positive and negative correlations between activity in component brain
regions. In several disorders, however this balance is disrupted (Fox and Raichle, 2007). Using well validated functional magnetic
resonance imaging (fMRI) paradigms to study the DMN (Fox et al., 2005), we investigated whether the impairments of chronic pain
patients could be rooted in disturbed DMN dynamics. Studying with fMRI a group of chronic back pain (CBP) patients and healthy
controls while executing a simple visual attention task, we discovered that CBP patients, despite performing the task equally well as
controls, displayed reduced deactivation in several key DMN regions. These findings demonstrate that chronic pain has a widespread
impact on overall brain function, and suggest that disruptions of the DMN may underlie the cognitive and behavioral impairments
accompanying chronic pain.
Key words: default-mode network; chronic pain; fMRI; resting state networks; functional connectivity; brain


Source: Apkarian, A. Vania - Department of Physiology, Northwestern University


Collections: Biology and Medicine