Aberrant resting-state functional connectivity of the dorsolateral prefrontal cortex to the anterior insula and its association with fear avoidance belief in chronic neck pain patients

• Published in: PloS one 2019-08, Vol.14 (8), p.e0221023-e0221023
• Main Authors: Ihara, Naho, Wakaizumi, Kenta, Nishimura, Daisuke, Kato, Jungo, Yamada, Takashige, Suzuki, Takeshi, Hashiguchi, Saori, Terasawa, Yuri, Kosugi, Shizuko, Morisaki, Hiroshi
• Format: Article
• Language: English
• Subjects: Adult; Anesthesiology; Arthritis; Avoidance; Back pain; Beliefs, opinions and attitudes; Biology and Life Sciences; Brain; Brain mapping; Chronic pain; Chronic Pain - diagnostic imaging; Chronic Pain - physiopathology; Cognition & reasoning; Complications and side effects; Computer and Information Sciences; Connectome; Cortex (cingulate); Cortex (insular); Demographic aspects; Disorders; Fear; Female; Functional magnetic resonance imaging; Global health; Health aspects; Humans; Magnetic resonance; Magnetic Resonance Imaging; Male; Medical imaging; Medical schools; Medicine; Medicine and Health Sciences; Mental disorders; Middle Aged; Neck; Neck pain; Neck Pain - diagnostic imaging; Neck Pain - physiopathology; Neural networks; Neural Pathways - diagnostic imaging; Neural Pathways - physiopathology; Neuroimaging; Neurosciences; NMR; Nuclear magnetic resonance; Pain; Pain management; Patients; Phobias; Physiological aspects; Prefrontal cortex; Prefrontal Cortex - diagnostic imaging; Prefrontal Cortex - physiopathology; Research and Analysis Methods; Risk factors; Somatotropin; Studies; Visual cortex; World health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0221023

Chronic neck pain (CNP), a global health problem, involves a large amount of psychological and socioeconomic burdens. Not only physical causes but also behavioral disorders such as a fear-avoidance belief (FAB) can associate with the chronicity of neck pain. However, functional brain mechanisms underlying CNP and its related behavioral disorders remain unknown. The aim of the current resting-state functional magnetic resonance imaging (fMRI) study was to explore how the functional brain networks differed between CNP patients and age- and sex-matched healthy, pain-free controls (HCs). We also investigated whether these possible brain network changes in CNP patients were associated with fear avoidance belief (FAB) and the intensity of pain. We analyzed the resting-state fMRI data of 20 CNP patients and 20 HCs. FAB and the intensity of pain were assessed by Tampa Scale for Kinesiophobia (TSK) and Visual Analog Scale (VAS) of pain. The whole brain analysis showed that CNP patients had significant different functional connectivity (FC) compared with HCs, and the right dorsolateral prefrontal cortex (DLPFC) was a core hub of these altered functional networks. Furthermore, general linear model analyses showed that, in CNP patients, the increased FC between the right DLPFC and the right anterior insular cortex (aIC) significantly associated with increased TSK (p = 0.01, statistical significance after Bonferroni correction: p