Risky monetary behavior in chronic back pain is associated with altered modular connectivity of the nucleus accumbens

BMC Research Notes

A Vania Apkarian¹  Thomas J Schnizter²  Elle L Parks³  Lejian Huang³  Souraya Torbey³  Kristi M Herrmann³  Ali Mansour³  Marwan N Baliki³  Alexis T Baria³  Sara E Berger³ 

[1] Departments of Anesthesia and Surgery, Northwestern University, Feinberg School of Medicine, 300 E. Superior St, 60611 Chicago, IL, USA;Department of Rheumatology, Northwestern University, Feinberg School of Medicine, 300 E. Superior St, 60611 Chicago, IL, USA;Department of Physiology, Northwestern University, Feinberg School of Medicine, 300 E. Superior St, 60611 Chicago, IL, USA

关键词: Chronic back pain;    Monetary risk;    Resting state;    Connectivity;    Nucleus accumbens;   

Others  :  1127196
DOI  :  10.1186/1756-0500-7-739

 received in 2014-07-02, accepted in 2014-10-02,  发布年份 2014

【 摘 要 】

Background

The nucleus accumbens (NAc) has a well established role in reward processing. Yet, there is growing evidence showing that NAc function, and its connections to other parts of the brain, is also critically involved in the emergence of chronic back pain (CBP). Pain patients are known to perform abnormally in reward-related tasks, which suggests an intriguing link between pain, NAc connectivity, and reward behavior. In the present study, we compared performance on a gambling task (indicating willingness to risk losing money) between healthy pain-free controls (CON) and individuals with CBP. We then measured modular connectivity of each participants’ NAc with resting state functional MRI to investigate how connectivity accounts for reward behavior in the presence and absence of pain.

Results

We found gain sensitivity was significantly higher in CBP patients. These scores were significantly correlated to connectivity within the NAc module defined by CON subjects ( which had strong connections to the frontal cortex), but not within that defined by CBP patients ( which was more strongly connected to subcortical areas). An important part of our study was based on the precedence that a range of behaviors, from simple to complex, can be predicted from brain activity during rest. Thus, to corroborate our results we compared them closely to an independent study correlating the same connectivity metric to impulsive behaviors in healthy participants. We found that our CBP patients were highly similarin connectivity to this study’s highly-impulsive healthy subjects, strengthening the notion that there is an important link between the brain systems that support chronic pain and reward processing.

Conclusions

Our results support previous findings that chronic back pain is accompanied by altered connectivity of the NAc. This lends itself to riskier behavior in these patients, a finding which establishes a potential cognitive consequence or co-morbidity of long-term pain and provides a behavioral link to growing research showing that chronic pain is related to abnormal changes in the dopaminergic system.

【 授权许可】

   
2014 Berger et al.; licensee BioMed Central Ltd.

【 图 表 】

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