Journal
NEUROIMAGE-CLINICAL
Volume 6, Issue -, Pages 347-369Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.nicl.2014.07.012
Keywords
Children; Resting state; Salience; fMRI; Pain
Categories
Funding
- NINDS [R01NS065051, K24 NS064050]
- Radiology and Anesthesia Foundations
- Boston Children's Hospital
- NICHD [K23 HD067202]
- Sara Page Mayo Endowment for Pediatric Pain Research and Treatment
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Pediatric complex regional pain syndrome (P-CRPS) offers a unique model of chronic neuropathic pain as it either resolves spontaneously or through therapeutic interventions in most patients. Here we evaluated brain changes in well-characterized children and adolescents with P-CRPS by measuring resting state networks before and following a brief (median = 3 weeks) but intensive physical and psychological treatment program, and compared them to matched healthy controls. Differences in intrinsic brain networks were observed in P-CRPS compared to controls before treatment (disease state) with the most prominent differences in the fronto-parietal, salience, default mode, central executive, and sensorimotor networks. Following treatment, behavioral measures demonstrated a reduction of symptoms and improvement of physical state (pain levels and motor functioning). Correlation of network connectivities with spontaneous pain measures pre- and post-treatment indicated concomitant reductions in connectivity in salience, central executive, default mode and sensorimotor networks (treatment effects). These results suggest a rapid alteration in global brain networks with treatment and provide a venue to assess brain changes in CRPS pre- and post-treatment, and to evaluate therapeutic effects. (C) 2014 The Authors. Published by Elsevier Inc.
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