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Whole-brain functional network disruption in chronic pain with disk herniation

Huang, Shishia,b; Wakaizumi, Kentac,d; Wu, Binbina,e; Shen, Banglia,e; Wu, Boa,f; Fan, Linyua; Baliki, Marwan N.c,d; Zhan, Gonghaoe; Apkarian, A. Vaniaa,g,h; Huang, Lejiana,g,*

doi: 10.1097/j.pain.0000000000001674
Research Paper
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Brain functional network properties are globally disrupted in multiple musculoskeletal chronic pain conditions. Back pain with lumbar disk herniation (LDH) is highly prevalent and a major route for progression to chronic back pain. However, brain functional network properties remain unknown in such patients. Here, we examined resting-state functional magnetic resonance imaging-based functional connectivity networks in chronic back pain patients with clear evidence for LDH (LDH-chronic pain n = 146), in comparison to healthy controls (HCs, n = 165). The study was conducted in China, thus providing the opportunity to also examine the influence of culture on brain functional reorganization with chronic pain. The data were equally subdivided into discovery and validation subgroups (n = 68 LDH-chronic pain and n = 68 HC, for each subgroup), and contrasted to an off-site data set (n = 272, NITRC 1000). Graph disruption indices derived from 3 network topological measurements, degree, clustering coefficient, and efficiency, which respectively represent network hubness, segregation, and integration, were significantly decreased compared with HC, across all predefined link densities, in both discovery and validation groups. However, global mean clustering coefficient and betweenness centrality were decreased in the discovery group and showed trend in the validation group. The relationship between pain and graph disruption indices was limited to males with high education. These results deviate somewhat from recent similar analysis for other musculoskeletal chronic pain conditions, yet we cannot determine whether the differences are due to types of pain or also to cultural differences between patients studied in China and the United States.

Brain functional network properties were globally disrupted in lumbar disk herniation patients with chronic pain. The relationship between pain and graph disruption indices was limited to males with high education.

aChina-USA Neuroimaging Research Institute, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China

bDepartment of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China

cShirley Ryan AbilityLab, Chicago, IL United States

dDepartment of Physical Management and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States

eDepartments of Pain Medicine and

fInformation, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China

gDepartment of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States

hDirector of Center for Translational Pain Research, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States

*Corresponding author. Address: Department of Physiology, Northwestern University, Chicago, IL, 60611, United States. Tel.: (312) 503-3195. E-mail address: lejian-huang@northwestern.edu (L. Huang).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

S. Huang and K. Wakaizumi contributed equally to this work.

© 2019 International Association for the Study of Pain
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