Distinct thalamocortical network dynamics are associated with the pathophysiology of chronic low back pain

Nat Commun. 2020 Aug 7;11(1):3948. doi: 10.1038/s41467-020-17788-z.


Thalamocortical dysrhythmia is a key pathology of chronic neuropathic pain, but few studies have investigated thalamocortical networks in chronic low back pain (cLBP) given its non-specific etiology and complexity. Using fMRI, we propose an analytical pipeline to identify abnormal thalamocortical network dynamics in cLBP patients and validate the findings in two independent cohorts. We first identify two reoccurring dynamic connectivity states and their associations with chronic and temporary pain. Further analyses show that cLBP patients have abnormal connectivity between the ventral lateral/posterolateral nucleus (VL/VPL) and postcentral gyrus (PoCG) and between the dorsal/ventral medial nucleus and insula in the less frequent connectivity state, and temporary pain exacerbation alters connectivity between the VL/VPL and PoCG and the default mode network in the more frequent connectivity state. These results extend current findings on thalamocortical dysfunction and dysrhythmia in chronic pain and demonstrate that cLBP pathophysiology and clinical pain intensity are associated with distinct thalamocortical network dynamics.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Brain Mapping
  • Case-Control Studies
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / physiopathology*
  • Chronic Pain / diagnosis
  • Chronic Pain / physiopathology*
  • Datasets as Topic
  • Female
  • Humans
  • Lateral Thalamic Nuclei / diagnostic imaging
  • Lateral Thalamic Nuclei / physiopathology*
  • Low Back Pain / diagnosis
  • Low Back Pain / physiopathology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nerve Net / physiopathology
  • Pain Measurement
  • Ventral Thalamic Nuclei / diagnostic imaging
  • Ventral Thalamic Nuclei / physiopathology*
  • Young Adult