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Sci Rep. 2018 May 10;8(1):7466. doi: 10.1038/s41598-018-25757-2.

Altered attentional control over the salience network in complex regional pain syndrome.

Kim J1,2, Kang I1,2, Chung YA3, Kim TS4, Namgung E1,2, Lee S1,2, Oh JK3, Jeong HS3, Cho H1, Kim MJ1,2, Kim TD1,2, Choi SH5, Lim SM6, Lyoo IK7,8,9, Yoon S10,11.

Author information

1
Ewha Brain Institute, Ewha Womnans University, Seoul, South Korea.
2
Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
3
Department of Radiology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, South Korea.
4
Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, South Korea.
5
School of Science and Engineering, Tulane University, New Orleans, USA.
6
Department of Radiology, Ewha Womans University College of Medicine, Seoul, South Korea.
7
Ewha Brain Institute, Ewha Womnans University, Seoul, South Korea. inkylyoo@ewha.ac.kr.
8
Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea. inkylyoo@ewha.ac.kr.
9
College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea. inkylyoo@ewha.ac.kr.
10
Ewha Brain Institute, Ewha Womnans University, Seoul, South Korea. sujungjyoon@ewha.ac.kr.
11
Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea. sujungjyoon@ewha.ac.kr.

Abstract

The degree and salience of pain have been known to be constantly monitored and modulated by the brain. In the case of maladaptive neural responses as reported in centralized pain conditions such as complex regional pain syndrome (CRPS), the perception of pain is amplified and remains elevated even without sustained peripheral pain inputs. Given that the attentional state of the brain greatly influences the perception and interpretation of pain, we investigated the role of the attention network and its dynamic interactions with other pain-related networks of the brain in CRPS. We examined alterations in the intra- and inter-network functional connectivities in 21 individuals with CRPS and 49 controls. CRPS-related reduction in intra-network functional connectivity was found in the attention network. Individuals with CRPS had greater inter-network connectivities between the attention and salience networks as compared with healthy controls. Furthermore, individuals within the CRPS group with high levels of pain catastrophizing showed greater inter-network connectivities between the attention and salience networks. Taken together, the current findings suggest that these altered connectivities may be potentially associated with the maladaptive pain coping as found in CRPS patients.

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