Abstract
Background
Chronic pain has been associated with alterations in brain connectivity, both within
networks (regional) and between networks (cross-network connectivity). Functional
connectivity (FC) data on chronic back pain are limited and based on heterogeneous
pain populations. Patients with postsurgical persistent spinal pain syndrome (PSPS)
type 2 are good candidates for spinal cord stimulation (SCS) therapy. We hypothesize
that 1) FC magnetic resonance imaging (fcMRI) scans can be safely obtained in patients
with PSPS type 2 with implanted therapeutic SCS devices and that 2) their cross-network
connectivity patterns are altered and involve emotion and reward/aversion functions.
Materials and Methods
Resting-state (RS) fcMRI (rsfcMRI) scans were obtained from nine patients with PSPS
type 2 implanted with therapeutic SCS systems and 13 age-matched controls. Seven RS
networks were analyzed, including the striatum.
Results
Cross-network FC sequences were safely obtained on a 3T MRI scanner in all nine patients
with PSPS type 2 with implanted SCS systems. FC patterns involving emotion/reward
brain circuitry were altered as compared with controls. Patients with a history of
constant neuropathic pain, experiencing longer therapeutic effects of SCS, had fewer
alterations in their connectivity patterns.
Conclusions
To our knowledge, this is the first report of altered cross-network FC involving emotion/reward
brain circuitry in a homogeneous population of patients with chronic pain with fully
implanted SCS systems, on a 3T MRI scanner. All rsfcMRI studies were safe and well
tolerated by all nine patients, with no detectable effects on the implanted devices.
Keywords
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Comment
Article info
Publication history
Published online: May 16, 2023
Accepted:
April 8,
2023
Received in revised form:
March 23,
2023
Received:
January 4,
2023
Publication stage
In Press Corrected ProofFootnotes
Source(s) of financial support: The authors reported funding from the Daniel M. Soref Charitable Trust and the Clinical and Translational Science Institute.
Conflict of Interest: The authors reported no conflict of interest.
Identification
Copyright
© 2023 Published by Elsevier Inc. on behalf of the International Neuromodulation Society.
