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Original Article

Exp Neurobiol 2023; 32(2): 110-118

Published online April 30, 2023

https://doi.org/10.5607/en23003

© The Korean Society for Brain and Neural Sciences

Aberrant Resting-state Functional Connectivity in Complex Regional Pain Syndrome: A Network-based Statistics Analysis

Haejin Hong1†, Chaewon Suh1,2†, Eun Namgung3, Eunji Ha1, Suji Lee1, Rye Young Kim1,4, Yumi Song1,2, Sohyun Oh1,2, In Kyoon Lyoo1,2,4, Hyeonseok Jeong5* and Sujung Yoon1,2*

1Ewha Brain Institute, Ewha Womans University, Seoul 03760, 2Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, 3Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, 4Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul 03760, 5Department of Radiology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea

Correspondence to: *To whom correspondence should be addressed.
Hyeonseok Jeong, TEL: 82-32-280-7309, FAX: 82-32-280-5244
e-mail: hsjeong@catholic.ac.kr
Sujung Yoon, TEL: 82-2-3277-6564, FAX: 82-2-3277-6562
e-mail: sujungjyoon@ewha.ac.kr
These authors contributed equally to this article.

Received: January 16, 2023; Revised: March 5, 2023; Accepted: March 6, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Complex regional pain syndrome (CRPS) is a chronic neuropathic pain disorder. Pain catastrophizing, characterized by magnification, rumination, and helplessness, increases perceived pain intensity and mental distress in CRPS patients. As functional connectivity patterns in CRPS remain largely unknown, we aimed to investigate functional connectivity alterations in CRPS patients and their association with pain catastrophizing using a whole-brain analysis approach. Twenty-one patients with CRPS and 49 healthy controls were included in the study for clinical assessment and resting-state functional magnetic resonance imaging. Between-group differences in whole-brain functional connectivity were examined through a Network-based Statistics analysis. Associations between altered functional connectivity and the extent of pain catastrophizing were also assessed in CRPS patients. Relative to healthy controls, CRPS patients showed higher levels of functional connectivity in the bilateral somatosensory subnetworks (components 1~2), but lower functional connectivity within the prefronto-posterior cingulate (component 3), prefrontal (component 4), prefronto-parietal (component 5), and thalamo-anterior cingulate (component 6) subnetworks (p<0.05, family-wise error corrected). Higher levels of functional connectivity in components 1~2 (β=0.45, p=0.04) and lower levels of functional connectivity in components 3~6 (β=-0.49, p=0.047) were significantly correlated with higher levels of pain catastrophizing in CRPS patients. Higher functional connectivity in the somatosensory subnetworks implicating exaggerated pain perception and lower functional connectivity in the prefronto-parieto-cingulo-thalamic subnetworks indicating impaired cognitive-affective pain processing may underlie pain catastrophizing in CRPS.

Graphical Abstract


Keywords: Complex regional pain syndrome, Pain catastrophizing, Functional magnetic resonance imaging, Neuroimaging