Abstract
The insular cortex (IC) and cingulate cortex (CC) are critically involved in pain
perception. Previously we demonstrated that fibromyalgia (FM) patients have greater
connectivity between the insula and default mode network at rest, and that changes
in the degree of this connectivity were associated with changes in the intensity of
ongoing clinical pain. In this study we more thoroughly evaluated the degree of resting-state
connectivity to multiple regions of the IC in individuals with FM and healthy controls.
We also investigated the relationship between connectivity, experimental pain, and
current clinical chronic pain. Functional connectivity was assessed using resting-state
functional magnetic resonance imaging in 18 FM patients and 18 age- and sex-matched
healthy controls using predefined seed regions in the anterior, middle, and posterior
IC. FM patients exhibited greater connectivity between 1) right mid IC and right mid/posterior
CC and right mid IC, 2) right posterior IC and left CC, and 3) right anterior IC and
left superior temporal gyrus. Healthy controls displayed greater connectivity between
left anterior IC and bilateral medial frontal gyrus/anterior cingulate cortex; and
left posterior IC and right superior frontal gyrus. Within the FM group, greater connectivity
between the IC and CC was associated with decreased pressure-pain thresholds.
Perspective
These data provide further support for altered resting-state connectivity between
the IC and other brain regions known to participate in pain perception/modulation,
which may play a pathogenic role in conditions such as FM. We speculate that altered
IC connectivity is associated with the experience of chronic pain in individuals with
FM.
Key words
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Article info
Publication history
Published online: May 07, 2014
Accepted:
April 15,
2014
Received in revised form:
April 7,
2014
Received:
February 17,
2014
Footnotes
E.I. and T.S.-W. contributed equally to this study.
This study was funded in part by National Institutes of Health/National Center for Complementary and Alternative Medicine grant K01-AT-01111-01 and in part by a grant from Pfizer Incorporated, Groton, CT (no. A0081211). T.S.-W. was supported by a grant of the Deutsche Forschungsgemeinschaft (GZ: SchM 2665/1-1). R.E.H. is supported by grants from the Dana Foundation and the Department of Defense (Army grant: DAMD-W81XWH-07-2-0050), and has previously consulted for Pfizer Inc. D.J.C. has previously consulted for Pfizer Inc. V.N. was supported by National Center for Complementary and Alternative Medicine, National Institutes of Health (R01-AT004714, P01-AT002048).
All other authors have no conflicts of interest to disclose.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
Identification
Copyright
© 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.
