DTI reveals altered structural connectivity of pain-associated regions in a genetic variant of small fiber neuropathy

Patients with small fiber neuropathy (SFN) suffer from chronic pain, which may lead to cerebral changes. Here, we studied structural network changes in idiopathic- and genetic-SFN compared to controls using diffusion-MRI. We found that for the genetic-SFN group pain-associated regions take a more prominent place in the network (in terms of nodal importance). Furthermore, in the genetic-SFN group, a higher nodal importance of pain-associated regions related to lower self-reported pain. This shows that genetic-SFN has a distinct structural pain pathway, which may be indicative of a compensatory mechanism where the structural organization is altered to inhibit the response to pain.