Poster No:
2526
Submission Type:
Abstract Submission
Authors:
Jeungchan Lee1, Alessandra Anzolin1, Asimina Lazaridou2, Myrella Paschali2, Dan-Mikael Ellingsen3, Arvina Grahl1, Marco Loggia4, Ajay Wasan5, Robert Edwards6, Vitaly Napadow7
Institutions:
1Spaulding Rehabilitation Hospital, Charlestown, MA, 2Brigham and Women's Hospital, Boston, MA, 3Oslo University Hospital, Oslo, Norway, 4A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 5University of Pittsburgh, Pittsburgh, PA, 6Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 7Massachusetts General Hospital, Harvard Medical School, Charlestown, MA
First Author:
Co-Author(s):
Arvina Grahl
Spaulding Rehabilitation Hospital
Charlestown, MA
Marco Loggia, PhD
A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School
Boston, MA
Ajay Wasan
University of Pittsburgh
Pittsburgh, PA
Vitaly Napadow
Massachusetts General Hospital, Harvard Medical School
Charlestown, MA
Introduction:
Previously we found that the posterior cingulate cortex (PCC) encodes pain catastrophizing in fibromyalgia (FM) patients (Lee et al., 2018), with distinct roles for different PCC subregions. For example, the level of self-reported engagement in catastrophizing thoughts was correlated with the activity in ventral PCC (vPCC, which supports self-referential cognition), while patients' pain severity was associated with activity in dorsal PCC (dPCC, which is associated with sensorimotor processing). It is not clear, however, if these different PCC subregions also show differential interactions with the rest of the brain during pain catastrophizing or sustained physical pain experience. In this study, we investigated functional connectivity for PCC subregions (vPCC and dPCC) in FM patients while they (separately) engaged in pain catastrophizing cognitions and experienced a sustained pain stimulus.
Methods:
We enrolled 99 FM patients (all female, 41.4±12.0 years). Neuroimaging (fMRI: 3T, TR/TE=1250/33 ms, voxel dimension=2 mm isotropic, multiband acceleration factor=5) data were collected during (1) 6-minutes resting-state (REST), (2) sustained (6-minutes) experimental pain (PAIN) where patients' left lower leg was stimulated with cuff pressure (target pain=40/100), and (3) a cognitive pain catastrophizing task wherein patients viewed catastrophizing (CAT, taken from the validated Pain Catastrophizing Scale) or neutral (NEU) statements (presented in randomized order) and reflected on the statements' applicability to their daily experience of FM pain. From the CAT fMRI task, catastrophizing-specific brain regions were calculated using the contrast between CAT and NEU, and PCC subregions were used as ROI for subsequent connectivity analyses. Psychophysiological interaction (PPI) analysis was performed for the CAT task dataset to identify whole-brain functional connectivity patterns for each ROI during pain catastrophizing blocks. Seed-based connectivity analysis was also performed to assess whole-brain functional connectivity for ROIs during evoked pain, contrasting PAIN and REST scan runs. All analyses were cluster-corrected for multiple comparisons (Z>3.1, P<0.05).
Results:
We found that CAT increased fMRI response in both PCC subregions (vPCC and dPCC) along with other default mode network (DMN) regions (vm/mPFC, PC, vlPFC, IPL, STS). However, during the pain catastrophizing period, vPCC was negatively correlated with other DMN subregions (PC, mPFC). In contrast, dPCC was negatively correlated with PC but positively correlated with the rest of the DMN (vlPFC, STS), dorsal attention network (DAN: SMA, PM), and frontoparietal network (FPN: dlPFC, ITG) subregions. In addition, compared to dPCC, vPCC showed greater anti-correlation with vmPFC during pain catastrophizing, while vmPFC was strongly and positively correlated with vPCC during both REST and PAIN states. In contrast, during REST and PAIN states, dPCC was more functionally connected with SLN (aMCC), FPN (FIC, dlPFC), and sensorimotor network (SMN: pINS) subregions, compared to vPCC. Interestingly, during PAIN, compared to REST, vPCC showed greater functional connectivity with SLN (aMCC, a/mINS), thalamus, SMN (S1/M1), SPL, and IPL. On the other hand, dPCC showed increased functional connectivity with SMA and thalamus during PAIN, compared to REST.
Conclusions:
Pain catastrophizing induced both differential activation and connectivity patterns in PCC subregions, vPCC and dPCC. Our results suggest that the canonical correlation between vPCC and vmPFC, comprising the default mode network, was reversed during pain-catastrophizing rumination. The distinguishable connectivity patterns of PCC subregions might support their distinct roles in the processing of different modalities of pain-cognitive processing and somatic self-awareness by ventral and somatosensory processing by dorsal PCC.
Modeling and Analysis Methods:
Connectivity (eg. functional, effective, structural) 2
Perception, Attention and Motor Behavior:
Perception: Pain and Visceral 1
Keywords:
FUNCTIONAL MRI
Pain
Other - fibromyalgia
1|2Indicates the priority used for review
Provide references using author date format
Lee, J. (2018), ‘Encoding of self-referential pain catastrophizing in posterior cingulate cortex in fibromyalgia’, Arthritis & Rheumatology, vol. 70, no. 8, pp. 1308-1318.