Division of Brain, Imaging, and Behaviour-Systems Neuroscience, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
Pain. 2018 Aug;159(8):1621-1630. doi: 10.1097/j.pain.0000000000001252.
Resilience is a psychological trait that strongly predicts chronic pain-related health outcomes. The neural correlates of both pain and trait resilience are critical to understand the brain-behaviour relationship in chronic pain; yet, neural correlates of resilience in chronic pain states are unknown. However, measures of pain perception and a wide range of psychological health measures have been linked to function of the default mode network (DMN). Thus, we aimed to determine the relationships between resilience, pain perception, and functional connectivity (FC) within the DMN and between the DMN and other brain networks. Resting-state functional magnetic resonance imaging data were acquired from 51 chronic pain patients with a form of spondylarthritis (ankylosing spondylitis) and 51 healthy control participants. Participants completed a questionnaire on their individual trait resilience (the Resilience Scale), and patients reported their clinical pain. In healthy controls, we found within-DMN FC to be stronger in less resilient individuals. In patients with chronic pain, individual resilience was negatively correlated with pain and disease activity. Cross-network FC between the DMN and the sensorimotor network was abnormally high in patients with high clinical pain scores on the day of the study. Finally, there was an interaction between within-DMN FC and clinical pain report in patients: In patients reporting greater pain, the relationship between within-DMN connectivity and resilience was atypical. Thus, our findings reveal different neural representations of resilience and pain. The way in which these behavioural measures interact provides insight into understanding the neural correlates of chronic pain.
韧性是一种强烈预测慢性疼痛相关健康结果的心理特征。疼痛和特质韧性的神经相关性对于理解慢性疼痛中的大脑-行为关系至关重要；然而，慢性疼痛状态下的韧性的神经相关性尚不清楚。然而，疼痛感知的测量和广泛的心理健康测量与默认模式网络（DMN）的功能相关。因此，我们旨在确定韧性、疼痛感知以及 DMN 内和 DMN 与其他大脑网络之间的功能连接（FC）之间的关系。从患有脊柱关节炎（强直性脊柱炎）的 51 名慢性疼痛患者和 51 名健康对照参与者中采集了静息状态功能磁共振成像数据。参与者完成了关于个体特质韧性（韧性量表）的问卷，患者报告了他们的临床疼痛。在健康对照组中，我们发现韧性较低的个体的 DMN 内 FC 更强。在慢性疼痛患者中，个体韧性与疼痛和疾病活动呈负相关。在研究当天临床疼痛评分较高的患者中，DMN 与感觉运动网络之间的跨网络 FC 异常高。最后，患者的 DMN 内 FC 与临床疼痛报告之间存在相互作用：报告疼痛较大的患者，DMN 内连接与韧性之间的关系异常。因此，我们的发现揭示了韧性和疼痛的不同神经表现。这些行为测量相互作用的方式提供了对理解慢性疼痛的神经相关性的深入了解。
