Aberrant Resting-state Functional Connectivity in Complex Regional Pain Syndrome: A Network-based Statistics Analysis

Abstract

Complex regional pain syndrome (CRPS) is a chronic neuropathic pain disorder characterized by hyperexcitability of the cen-tral nervous system and hypersensitivity to pain [1,2]. Sustained pain-related rumination, feeling of helplessness, and magnification of pain intensity are commonly observed symptoms of CRPS [1]. Considering the debilitating effects of CRPS on life quality, CRPS is a critical health problem, necessitating the development of strategies for prevention and intervention [3,4]. As the central hyper-sensitization underlies the mechanisms of CRPS [2], the pathophysiological mechanisms in the nervous system should be investigated in relation to .Previous studies have suggested that the chronic pain conditions may be closely related to the functional balance among somatosensory perception, sensory gating, and cognitive control [6][7][8].

A Case of a Father and Son With Complex Regional Pain Syndrome Type 1 Exhibiting Different Resting-State Functional Connectivity on Functional MRI

“…Prior research has identified abnormalities in rsFC within multiple brain networks in patients with CRPS. These networks include the fronto-parietal [ 4 , 6 ], motor [ 3 , 7 , 10 ], somatosensory [ 5 , 6 , 11 ], subcortical [ 3 , 6 , 10 , 11 ], salience [ 4 , 8 , 9 ], central executive [ 4 ], and default mode [ 4 , 5 ] networks. These brain network alterations can be classified into two broad categories.…”

“…Brodmann area 10, to which the rostral PFC belongs, plays a crucial role in the nociceptive process, including the integration and higher-order processing of nociception and pain [ 15 ]. This region is part of the prefrontal-parietal-thalamic circuit [ 15 ], and in patients with CRPS, a significant correlation has been identified between decreased rsFC within this subnetwork’s brain regions and deficits in cognitive-emotional pain processing [ 4 , 6 ]. Moreover, the OFC is involved in processing multifaceted external and internal sensory and emotional information and integrating cognitive functions through signal exchange with other regions, including the medial striatum, the mediodorsal thalamus, and additional prefrontal areas [ 16 ].…”

“…These brain network alterations can be classified into two broad categories. The first category includes abnormalities in pain sensation [3][4][5][6][7][8][9]11] and cognitive-emotional changes [6,8]. The second involves limb movement disorders such as dystonia [3,4,10].…”

“…Complex regional pain syndrome (CRPS) is a chronic pain syndrome that develops following fractures, soft tissue damage, or surgery and is characterized by pain, swelling, limited range of joint motion, vasomotor instability, skin changes, and patchy osteoporosis [1,2]. Although the pathogenesis is uncertain, classic and neurogenic inflammation in the affected limb's peripheral tissues and central nervous system pathophysiology, such as changes in nociceptive perception, contribute to its occurrence [1,2] Resting-state functional connectivity (rsFC) changes observed on functional magnetic resonance imaging (fMRI) have been recently investigated as indicators of central nervous system abnormalities in patients with CRPS [3][4][5][6][7][8][9][10][11]. Advanced research has identified various rsFC anomalies that are associated with alterations in pain perception and cognitive processes [3][4][5][6][7][8][9]11].…”

“…Although the pathogenesis is uncertain, classic and neurogenic inflammation in the affected limb's peripheral tissues and central nervous system pathophysiology, such as changes in nociceptive perception, contribute to its occurrence [1,2] Resting-state functional connectivity (rsFC) changes observed on functional magnetic resonance imaging (fMRI) have been recently investigated as indicators of central nervous system abnormalities in patients with CRPS [3][4][5][6][7][8][9][10][11]. Advanced research has identified various rsFC anomalies that are associated with alterations in pain perception and cognitive processes [3][4][5][6][7][8][9]11]. Some of these anomalies are also related to motor function disturbances [3,4,10].…”