Beyond Feeling: Chronic Pain Hurts the Brain, Disrupting the Default-Mode Network Dynamics

Baliki, Marwan N.; Geha, Paul; Apkarian, A. Vania; Chialvo, Dante R.

doi:10.1523/jneurosci.4123-07.2008

Cited by 702 publications

(587 citation statements)

References 32 publications

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“…33 Another possible explanation is that the ongoing pain leads to more generalized changes, affecting the baseline state, and leading to an altered response to evoked pain. 6 This explanation is congruent with a study by Baliki et al 34 who reported changes in the default brain activity in chronic pain patients in comparison with healthy controls. This disruption of the default state network may explain the different activation pattern observed in clinical pain studies than in healthy controls, as well as the cognitive and behavioral impairment reported in chronic pain patients.…”

Section: Experimental and Clinical Pain: Same Or Different Brain Regisupporting

confidence: 87%

Neuroimaging as a Tool for Pain Diagnosis and Analgesic Development

Wartolowska

Tracey

2009

Neurotherapeutics

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Summary:Neuroimaging makes it possible to study pain processing beyond the peripheral nervous system, at the supraspinal level, in a safe, noninvasive way, without interfering with neurophysiological processes. In recent years, studies using brain imaging methods have contributed to our understanding of the mechanisms responsible for the development and maintenance of chronic pain. Moreover, neuroimaging shows promising results for analgesic drug development and in characterizing different types of pain, bringing us closer to development of mechanism-based diagnoses and treatments for the chronic pain patient.

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Section: Experimental and Clinical Pain: Same Or Different Brain Regisupporting

confidence: 87%

Neuroimaging as a Tool for Pain Diagnosis and Analgesic Development

Wartolowska

Tracey

2009

Neurotherapeutics

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“…These findings raise an intriguing possibility, namely, that intrinsic attention to pain might interact with ongoing nociceptive input in chronic pain to determine the course of pain-related structural brain reorganization and disease prognosis. Supporting this notion are findings of aberrant DMN function in chronic pain disorders (47,48). Of particular note, longitudinal studies point to a potential causal role of DMN-insula interactions in pain reduction in fibromyalgia (49) and of mPFC-nucleus accumbens interactions in the transition from subacute to chronic back pain (50).…”

Section: Discussionmentioning

confidence: 94%

Mind wandering away from pain dynamically engages antinociceptive and default mode brain networks

Kucyi

Salomons

Davis

2013

Proc. Natl. Acad. Sci. U.S.A.

339

314

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Human minds often wander away from their immediate sensory environment. It remains unknown whether such mind wandering is unsystematic or whether it lawfully relates to an individual's tendency to attend to salient stimuli such as pain and their associated brain structure/function. Studies of pain-cognition interactions typically examine explicit manipulation of attention rather than spontaneous mind wandering. Here we sought to better represent natural fluctuations in pain in daily life, so we assessed behavioral and neural aspects of spontaneous disengagement of attention from pain. We found that an individual's tendency to attend to pain related to the disruptive effect of pain on his or her cognitive task performance. Next, we linked behavioral findings to neural networks with strikingly convergent evidence from functional magnetic resonance imaging during pain coupled with thought probes of mind wandering, dynamic resting state activity fluctuations, and diffusion MRI. We found that (i) pain-induced default mode network (DMN) deactivations were attenuated during mind wandering away from pain; (ii) functional connectivity fluctuations between the DMN and periaqueductal gray (PAG) dynamically tracked spontaneous attention away from pain; and (iii) across individuals, stronger PAG-DMN structural connectivity and more dynamic resting state PAG-DMN functional connectivity were associated with the tendency to mind wander away from pain. These data demonstrate that individual tendencies to mind wander away from pain, in the absence of explicit manipulation, are subserved by functional and structural connectivity within and between default mode and antinociceptive descending modulation networks.pain modulation | salience network | stimulus-independent thought | ventral attention network | experience sampling H umans spend nearly half their time on thoughts unrelated to their present sensory environment (1), a phenomenon referred to as "mind wandering." These thoughts can persist even when engaged in salient and challenging everyday activities (1, 2), such as driving a car through traffic. In such situations, mind wandering can be deleterious. However, in some situations, mind wandering may be beneficial, such as when an individual needs to cope with pain.Cognitive manipulations, such as alterations of attention/distraction (3-5), placebo effects (6-9), changing expectations, and other strategies (10), have shown some efficacy in altering perceptions and neural responses elicited by painful stimuli. It is generally assumed that these effects involve enhanced endogenous analgesic activity within the descending pain modulatory system [e.g., prefrontal cortex, perigenual cingulate cortex, periaqueductal gray (PAG), and rostroventral medulla] and decreased activity in regions that support the salience of pain [e.g., insula and midcingulate cortex (MCC)] (10).A crucial assumption in previous studies of explicit pain manipulation is that there is a static, invariant neurocognitive state during incoming nociceptive activit...

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“…Though preliminary, this phenomenon may reflect the specific neuro-modulatory effect of acupuncture on the resting brain [39,40]. In addition, a recent study has reported differences in resting-state brain functions of people with chronic pain in contrast with controls, and the authors proposed that this difference in resting-state brain activity might reflect the cognitive and affective complications of chronic pain [41]. Along these lines, exploration of the alternating interplay between the external acupuncture intervention and the organization of resting-state networks, can not only help us better understand the long-term effects of pain on the brain, but also the potential benefits of acupuncture in pain treatments.…”

Section: Sustained Effects Of Acupuncture and Its Influence On Fmri Rmentioning

confidence: 93%

Spatiotemporal Modulation of Central Neural Pathway Underlying Acupuncture Action: A Systematic Review

Bai¹,

Qin²,

Liang³

et al. 2009

CMIR

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Acupuncture, an ancient therapeutic technique, is currently gaining popularity as an important modality of alternative and complementary medicine in the West world. Concurrently, scientific interests in exploring whether acupuncture is therapeutically effective are raised alongside those about the means by which it may operate. Modern neuroimaging techniques such as functional magnetic resonance imaging, positron emission tomography, electroencephalography, and magnetoencephalography provide a means to safely monitor brain activity in humans. In this review, we have summarized evidence derived from the neuroimaging studies and tried to elucidate the neurophysiological correlates of acupuncture. Previous investigations on the neural responses to acupuncture mainly focus on its acute effects and explore the correlation between the specific acupoints and cortical activations only in the spatial domain. However, abundant clinical reports and psychophysical analysis suggest the kinetics of acupuncture is longer acting as a function of time. Consequentially, an accurate interpretation of acupuncture actions depends on how effectively we can characterize the nature of temporal variations underlying neural activities, rather than simply detect the occurrence of such changes. This emerging picture indicates that both designing paradigms and statistical models involved in acupuncture studies should be applied with great care.

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Beyond Feeling: Chronic Pain Hurts the Brain, Disrupting the Default-Mode Network Dynamics

Cited by 702 publications

References 32 publications

Neuroimaging as a Tool for Pain Diagnosis and Analgesic Development

Neuroimaging as a Tool for Pain Diagnosis and Analgesic Development

Mind wandering away from pain dynamically engages antinociceptive and default mode brain networks

Spatiotemporal Modulation of Central Neural Pathway Underlying Acupuncture Action: A Systematic Review

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