# Multi-network dynamical structure of the human brain in the setting of chronic pain: a coordinate-based meta-analysis

## TL;DR

This study maps brain networks involved in chronic pain using MRI data, revealing disruptions in three key networks.

## Contribution

The first anatomically specific cortical map of chronic pain showing tripartite network dysfunction.

## Key findings

- Chronic pain involves dysfunction in the Default Mode Network, Central Executive Network, and Salience Network.
- Chronic visceral pain differs from headache and musculoskeletal pain in network disruption patterns.
- Pain mechanisms share cortical rearrangements with their respective pain conditions.

## Abstract

The treatment of chronic pain represents a widespread clinical challenge. Current approaches to network-based mapping of the cerebral cortex have the potential to localize chronic pain in the brain. In an effort to further characterize the dynamical brain networks, or the ‘dynome’ in the setting of chronic pain, we performed a Coordinate-Based Meta-Analysis of resting-state functional Magnetic Resonance Imaging studies on chronic pain to create a multinetwork dynome of chronic pain. A cluster-level analysis generated seven statistically significant activation likelihood estimates (ALEs): one for chronic pain as a whole dynome, three for chronic pain conditions, and three for chronic pain mechanisms. Chronic pain is a complex disease process involving tripartite network dysfunction encompassing the Default Mode Network, Central Executive Network and Salience Network. Chronic visceral pain was distinct from chronic headache and chronic musculoskeletal pain, and chronic pain mechanisms have the potential to share common cortical network rearrangements with their respective chronic pain conditions. Collectively, this work represents the first anatomically specific network-based cortical map of chronic pain, with representation of disease-specific and mechanism-specific disruptions in cortical function.

Dhanaraj et al. report that chronic pain involves tripartite network dysfunction encompassing the Default Mode Network, Central Executive Network, and the Salience Network. Their Coordinate-Based Meta-Analysis of resting-state functional MRI studies provides an anatomically specific network-based cortical map of chronic pain, highlighting disruptions in cortical function for different pain conditions.

Graphical Abstract