Research has indicated that the default mode network (DMN) is perturbated in patients with chronic pain when compared with healthy controls, and this perturbation is correlated with the duration of pain during the chronic pain stage. It remains unclear whether DMN adaptations manifest during the subacute pain stage and progress over time because of the duration of pain experience, rather than being a specific correlate of the chronic pain stage. Furthermore, information regarding whether these adaptations are related to cognitive processes of adaptation is lacking. To this end, we examined the DMN in 31 patients with chronic back pain (CBP), 77 patients with subacute back pain (SBP), as well as 39 healthy pain-free controls (HC) applying a graph-theoretic network approach on functional resting-state magnetic resonance imaging. Beyond the comparison between groups, we used a linear analysis considering the years lived with pain (YLP) across all patients with back pain and additionally performed a mediation analysis of the role of cognitive pain coping. In line with previous studies, we found significant DMN perturbation in CBP compared with HC. However, this did not apply to the comparison of CBP with SBP. Instead, we observed a positive correlation between DMN perturbation and YLP. This was significantly mediated by coping attitudes towards pain. Default mode network perturbation may thus reflect neural adaptation processes to pain experience rather than a single correlate of the chronic pain stage and be modulated by cognitive adaption. This points to potentially underinvestigated significant adaptation processes that could enable more fine-grained patient stratification.

中文翻译：

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超过慢性疼痛阶段：默认模式网络扰动取决于背痛的寿命。


研究表明，与健康对照组相比，慢性疼痛患者的默认模式网络 （DMN） 受到扰动，并且这种扰动与慢性疼痛阶段的疼痛持续时间相关。目前尚不清楚 DMN 适应是否在亚急性疼痛阶段表现出来，并且由于疼痛体验的持续时间而随着时间的推移而进展，而不是慢性疼痛阶段的特定相关性。此外，缺乏关于这些适应是否与适应的认知过程相关的信息。为此，我们检查了 31 名慢性背痛 （CBP） 患者、77 名亚急性背痛 （SBP） 患者以及 39 名健康无痛对照 （HC） 的 DMN，应用图论网络方法进行功能性静息态磁共振成像。除了组间比较之外，我们还使用了线性分析，考虑了所有背痛患者的疼痛寿命 （YLP），并额外对认知疼痛应对的作用进行了中介分析。与之前的研究一致，我们发现与 HC 相比，CBP 存在显着的 DMN 扰动。然而，这并不适用于 CBP 与 SBP 的比较。相反，我们观察到 DMN 扰动与 YLP 之间存在正相关。这在很大程度上是由应对对疼痛的态度介导的。因此，默认模式网络扰动可能反映了神经适应过程对疼痛体验的适应过程，而不是慢性疼痛阶段的单一相关性，并受到认知适应的调节。这表明可能未被充分研究的重要适应过程可以实现更精细的患者分层。