Abstract
Chronic pain is a multidimensional pathological state. Recent evidence suggests that specific brain properties and patients' psychological and physical traits are distorted in chronic pain patients. However, the relationship between these alterations and pain dimensions remains poorly understood. Here, we first evaluated multiple dimensions of chronic pain by assessing a broad battery of pain-related questionnaire scores (23 outcomes) of 107 chronic low back pain patients and identified 3 distinct chronic pain domains: magnitude, affect & disability, and quality. Second, we investigated the pain domains relationship with measures of personality, social interaction, psychological traits, and ability traits (77 biopsychosocial & ability [biopsy&ab] outcomes). Pain magnitude (out-of-sample [OOS] r2=0.33) is associated with emotional control, attention, and working memory, with higher pain scores showing lower capacity to regulate and adapt behaviorally. Pain affect & disability (OOS r2=0.79) associated with anxiety, catastrophizing and social relationships dysfunction. Pain quality did not relate significantly to biopsy&ab variables. Third, we mapped these 3 pain domains to brain functional connectivity. Pain magnitude mainly associated with the sensorimotor and the cingulo-opercular networks (OOS r2=0.41). Pain affect & disability related to frontoparietal and default mode networks (OOS r2=0.35). Pain quality integrated sensorimotor, auditory, and cingulo-opercular networks (OOS r2=0.43). Mediation analysis could link functional connectivity and biopsy&ab models to respective pain domains. Our results provide a global overview of the complexity of chronic pain, showing how underlying distinct domains of the experience map to different biopsy&ab correlates and underlie unique brain network signatures.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 59-71 |
| Number of pages | 13 |
| Journal | Pain |
| Volume | 164 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2023 |
Funding
Acknowledgements The authors want to thank all the members of the Apkarian laboratory for their contributions and discussion in this work. The authors would also like to thank all study participants for their time and participation in this study A.V. Apkarian, C.B. Pinto, and J. Bielefeld designed the research. C.B. Pinto and J. Bielefeld performed the data analysis. C.B. Pinto and J. Bielefeld drafted the manuscript. A.V. Apkarian, J. Barroso, MB, and T. Schnitzer provided intellectual advice. A.V. Apkarian and J. Barroso revised the manuscript. BY coordinates the study. L. Huang preprocessed the fMRI data. T. Schnitzer provided clinical oversight over the study. All authors contributed to the article and approved the submitted version. This work was funded by Center for chronic pain and drug abuse 1P50DA044121-01A1, Department of Defense award # W81XWH-17-1-0426 and J. Bielefeld received funding from T32AR007611.
Keywords
- Aspects of pain
- Brain functional connectivity
- Human ability
- NIH Toolbox
- Pain predictions
- Personality and character
ASJC Scopus subject areas
- Clinical Neurology
- Neurology
- Anesthesiology and Pain Medicine
