Open AccessImpaired insula functional connectivity associated with persistent pain perception in patients with complex regional pain syndrome
Author(s) -
JaeHun Kim,
Seong Hee Choi,
Joon Hwan Jang,
Do Hyeong Lee,
Kyung Jun Lee,
Won Joon Lee,
Jee Youn Moon,
Yong Chul Kim,
Do Hyung Kang
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0180479
Subject(s) - insula , complex regional pain syndrome , insular cortex , functional magnetic resonance imaging , postcentral gyrus , somatosensory system , sensory system , neuroscience , medicine , secondary somatosensory cortex , anterior cingulate cortex , psychology , sensation , resting state fmri , physical therapy , cognition
Given that the insula plays a contributory role in the perception of chronic pain, we examined the resting-state functional connectivity between the insular cortex and other brain regions to investigate neural underpinnings of persisting perception of background pain in patients with complex regional pain syndrome (CRPS). A total of 25 patients with CRPS and 25 matched healthy controls underwent functional magnetic resonance imaging at rest. With the anterior and posterior insular cortices as seed regions, we compared the strength of the resting-state functional connectivity between the two groups. Functional connectivity between the anterior and posterior insular cortices and the postcentral and inferior frontal gyri, cingulate cortices was reduced in patients with CRPS compared with controls. Additionally, greater reductions in functional connectivity between the anterior insula and right postcentral gyrus were associated with more severe sensory pain in patients with CRPS (short-form McGill Pain Questionnaire sensory subscores, r = -.517, P = .023). The present results imply a possible role of the insula in aberrant processing of pain information in patients with CRPS. The findings suggest that a functional derangement of the connection between one of the somatosensory cortical functions of perception and one of the insular functions of awareness can play a significant role in the persistent experience of regional pain that is not confined to a specific nerve territory.