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Papers of the Week

Papers: 23 Sep 2023 - 29 Sep 2023

Basic Science

Human Studies, Neurobiology, Neuroimaging

Inflammation/Inflammatory, Musculoskeletal Pain, Neuropathic Pain

2023 Sep 26



Large-scale momentary brain co-activation patterns are associated with hyperalgesia and mediate focal neurochemistry and cross-network functional connectivity in fibromyalgia.


Mawla I, Huang Z, Kaplan CM, Ichesco E, Waller N, Larkin TE, Zöllner HJ, Edden RAE, Harte SE, Clauw DJ, Mashour GA, Napadow V, Harris RE


Fibromyalgia has been characterized by augmented cross-network functional communication between the brain’s sensorimotor, default mode, and attentional (salience/ventral and dorsal) networks. However, the underlying mechanisms of these aberrant communication patterns are unknown. In this study, we sought to understand large-scale topographic patterns at instantaneous timepoints, known as co-activation patterns (CAPs). We found that a sustained pressure pain challenge temporally modulated the occurrence of CAPs. Using proton magnetic resonance spectroscopy, we found that greater basal excitatory over inhibitory neurotransmitter levels within the anterior insula orchestrated higher cross-network connectivity between the anterior insula and the default mode network through lower occurrence of a CAP encompassing the attentional networks during sustained pain. Moreover, we found that hyperalgesia in fibromyalgia was mediated through increased occurrence of a CAP encompassing the sensorimotor network during sustained pain. In conclusion, this study elucidates the role of momentary large-scale topographic brain patterns in shaping noxious information in patients with fibromyalgia, while laying the groundwork for using precise spatiotemporal dynamics of the brain for the potential development of therapeutics.