Intrinsic brain networks normalize with treatment in pediatric complex regional pain syndrome

Autor: Charles B. Berde, Simona Sava, Athena M. Drosos, Navil F. Sethna, Laura E. Simons, David Borsook, Alyssa Lebel, Lino Becerra
Rok vydání: 2014
Předmět:
Zdroj: NeuroImage : Clinical
NeuroImage: Clinical, Vol 6, Iss C, Pp 347-369 (2014)
ISSN: 2213-1582
DOI: 10.1016/j.nicl.2014.07.012
Popis: 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.
Highlights • Pediatric complex regional pain syndrome (CRPS) alters brain networks. • Alterations are not equivalent to those observed in adults with CRPS. • Identifying alterations might be relevant to determine treatment modalities. • Intensive physical- and psycho-therapy reverses some but not all the changes.
Databáze: OpenAIRE