Functional Reorganization of the Default Mode Network across Chronic Pain Conditions
PLoS ONE September 2, 2014 Marwan N. Baliki, Ali Mansour, Alex T. Baria et al. 539 citations
Chronic pain reorganizes the brain's default mode network (DMN). Using resting-state functional magnetic resonance imaging, patients with chronic back pain, complex regional pain syndrome, and knee osteoarthritis all showed reduced connectivity between the medial prefrontal cortex and posterior DMN regions, alongside increased connectivity to the insular cortex proportional to pain intensity. Multiple DMN regions, especially the medial prefrontal cortex, exhibited increased high-frequency oscillations and decreased phase locking with parietal attention-processing regions. Both phase and frequency changes correlated with pain duration in osteoarthritis and chronic back pain patients. These findings suggest chronic pain reflects maladaptive neural dynamics across different pain types.