Low-frequency BOLD fluctuations demonstrate altered thalamocortical connectivity in diabetic neuropathic pain

Abstract

BackgroundIn this paper we explored thalamocortical functional connectivity in a group of eight patients suffering from peripheral neuropathic pain (diabetic pain), and compared it with that of a group of healthy subjects. We hypothesized that functional interconnections between the thalamus and cortex can be altered after years of ongoing chronic neuropathic pain.ResultsFunctional connectivity was studied through a resting state functional magnetic resonance imaging (fMRI) paradigm: temporal correlations between predefined regions of interest (primary somatosensory cortex, ventral posterior lateral thalamic nucleus, medial dorsal thalamic nucleus) and the rest of the brain were systematically investigated. The patient group showed decreased resting state functional connectivity between the thalamus and the cortex.ConclusionThis supports the idea that chronic pain can alter thalamocortical connections causing a disruption of thalamic feedback, and the view of chronic pain as a thalamocortical dysrhythmia.

Cortical astrocytes rewire somatosensory cortical circuits for peripheral neuropathic pain

“…However, whole-brain imaging studies in patients with chronic neuropathic pain clearly identifies a range of plastic changes at the supraspinal level that include alterations of somatotopic maps, cortical thickness, and excitability in the S1 cortex (15,(40)(41)(42). Such anatomical and functional changes in the connectivity between the "pain matrix" cortical regions are reliable predictors for the severity of peripheral neuropathic pain (43,44). Our results extend this to show that changes in cortical neural circuits are not simply passive reflections of ongoing altered afferent input from the spinal areas, but actively contribute to neuropathic mechanical allodynia.…”

An Approach to Identify Nerve Injury-Evoked Changes that Contribute to the Development or Protect Against the Development of Sustained Neuropathic Pain

“…It is well accepted that chronic pain, ultimately reflects functional changes in the brain, in particular in the thalamocortical connections/interactions (Cauda et al, 2009;Cheong et al, 2011;Walton et al, 2010). With respect to structural cortical changes, most of those that have been found to be associated with neuropathic pain have been observed in animals and patients that have been experiencing neuropathic pain for a long period.…”

HIV Distal Neuropathic Pain Is Associated with Smaller Ventral Posterior Cingulate Cortex

“…Brain imaging has revealed the impact of peripheral neuropathy on the central nervous system. For example, in diabetic neuropathy the somatosensory cortex is smaller [7] while in painful diabetic neuropathy resting state network connectivity is altered [20][21][22].…”