Loss of nucleus accumbens low-frequency fluctuations is a signature of chronic pain
Open Access
- 20 April 2020
- journal article
- research article
- Published by Proceedings of the National Academy of Sciences in Proceedings of the National Academy of Sciences of the United States of America
- Vol. 117 (18), 10015-10023
- https://doi.org/10.1073/pnas.1918682117
Abstract
Chronic pain is a highly prevalent disease with poorly understood pathophysiology. In particular, the brain mechanisms mediating the transition from acute to chronic pain remain largely unknown. Here, we identify a subcortical signature of back pain. Specifically, subacute back pain patients who are at risk for developing chronic pain exhibit a smaller nucleus accumbens volume, which persists in the chronic phase, compared to healthy controls. The smaller accumbens volume was also observed in a separate cohort of chronic low-back pain patients and was associated with dynamic changes in functional connectivity. At baseline, subacute back pain patients showed altered local nucleus accumbens connectivity between putative shell and core, irrespective of the risk of transition to chronic pain. At follow-up, connectivity changes were observed between nucleus accumbens and rostral anterior cingulate cortex in the patients with persistent pain. Analysis of the power spectral density of nucleus accumbens resting-state activity in the subacute and chronic back pain patients revealed loss of power in the slow-5 frequency band (0.01 to 0.027 Hz) which developed only in the chronic phase of pain. This loss of power was reproducible across two cohorts of chronic low-back pain patients obtained from different sites and accurately classified chronic low-back pain patients in two additional independent datasets. Our results provide evidence that lower nucleus accumbens volume confers risk for developing chronic pain and altered nucleus accumbens activity is a signature of the state of chronic pain.Keywords
Funding Information
- HHS | NIH | National Institute on Drug Abuse (5K08DA037525)
- Yale | Yale School of Medicine (n/a)
This publication has 88 references indexed in Scilit:
- FreeSurferNeuroImage, 2012
- Corticostriatal functional connectivity predicts transition to chronic back painNature Neuroscience, 2012
- Spurious but systematic correlations in functional connectivity MRI networks arise from subject motionNeuroImage, 2012
- A Bayesian model of shape and appearance for subcortical brain segmentationNeuroImage, 2011
- Aberrant temporal and spatial brain activity during rest in patients with chronic painProceedings of the National Academy of Sciences of the United States of America, 2010
- The oscillating brain: Complex and reliableNeuroImage, 2010
- The Reward Circuit: Linking Primate Anatomy and Human ImagingNeuropsychopharmacology, 2009
- Dopamine reward circuitry: Two projection systems from the ventral midbrain to the nucleus accumbens–olfactory tubercle complexBrain Research Reviews, 2007
- A component based noise correction method (CompCor) for BOLD and perfusion based fMRINeuroImage, 2007
- The Pain Catastrophizing Scale: Development and validation.Psychological Assessment, 1995