Journal
HUMAN BRAIN MAPPING
Volume 43, Issue 3, Pages 998-1010Publisher
WILEY
DOI: 10.1002/hbm.25702
Keywords
ABC; ALE; chronic pain; functional magnetic resonance imaging; meta-analysis
Funding
- National Key Research and Development Program of China [2018YFA0701400]
- National Natural Science Foundation of China [NSFC31700998]
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Neuroimaging meta-analysis revealed neurofunctional dysregulations in the left anterior insula cortex of chronic pain patients, indicating a high probability of specific activation during pain-related processes and potential use as a treatment target in chronic pain disorders.
Neurobiological pain models propose that chronic pain is accompanied by neurofunctional changes that mediate pain processing dysfunctions. In contrast, meta-analyses of neuroimaging studies in chronic pain conditions have not revealed convergent evidence for robust alterations during experimental pain induction. Against this background, the present neuroimaging meta-analysis combined three different meta-analytic approaches with stringent study selection criteria for case-control functional magnetic resonance imaging experiments during acute pain processing with a focus on chronic pain disorders. Convergent neurofunctional dysregulations in chronic pain patients were observed in the left anterior insula cortex. Seed-based resting-state functional connectivity based on a large publicly available dataset combined with a meta-analytic task-based approach identified the anterior insular region as a key node of an extended bilateral insula-fronto-cingular network, resembling the salience network. Moreover, the meta-analytic decoding showed that this region presents a high probability to be specifically activated during pain-related processes, although we cannot exclude an involvement in autonomic processes. Together, the present findings indicate that dysregulated left anterior insular activity represents a robust neurofunctional maladaptation and potential treatment target in chronic pain disorders.
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