Key result
Complex regional pain syndrome is linked to greater attention and salience network connectivity versus controls.
Why the study?
The role of attentional control and its interaction with pain-related brain networks in complex regional pain syndrome was not well understood.
Case-Control (n=70)
No
Individuals with CRPS exhibit enhanced functional connectivity between the attention and salience networks, which correlates with pain catastrophizing and suggests maladaptive pain coping mechanisms.
Altered attention-salience connectivity may link to maladaptive pain coping in CRPS; leaves open whether network-targeted interventions alter clinical outcomes.
The degree and salience of pain have been known to be constantly monitored and modulated by the brain. In the case of maladaptive neural responses as reported in centralized pain conditions such as complex regional pain syndrome (CRPS), the perception of pain is amplified and remains elevated even without sustained peripheral pain inputs. Given that the attentional state of the brain greatly influences the perception and interpretation of pain, we investigated the role of the attention network and its dynamic interactions with other pain-related networks of the brain in CRPS. We examined alterations in the intra- and inter-network functional connectivities in 21 individuals with CRPS and 49 controls. CRPS-related reduction in intra-network functional connectivity was found in the attention network. Individuals with CRPS had greater inter-network connectivities between the attention and salience networks as compared with healthy controls. Furthermore, individuals within the CRPS group with high levels of pain catastrophizing showed greater inter-network connectivities between the attention and salience networks. Taken together, the current findings suggest that these altered connectivities may be potentially associated with the maladaptive pain coping as found in CRPS patients.
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Kim et al. (2018) conducted a case-control in Complex regional pain syndrome (CRPS) (n=70). Complex regional pain syndrome vs. Healthy controls was evaluated on Inter-network functional connectivity between the attention and salience networks (ES 0.63, p=0.02). Individuals with complex regional pain syndrome exhibited significantly greater inter-network functional connectivity between the attention and salience networks compared to healthy controls (ES 0.63).
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