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Corticostriatal functional connectivity predicts transition to chronic back pain


The mechanism of brain reorganization in pain chronification is unknown. In a longitudinal brain imaging study, subacute back pain (SBP) patients were followed over the course of 1 year. When pain persisted (SBPp, in contrast to recovering SBP and healthy controls), brain gray matter density decreased. Initially greater functional connectivity of nucleus accumbens with prefrontal cortex predicted pain persistence, implying that corticostriatal circuitry is causally involved in the transition from acute to chronic pain.

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Figure 1: Changes in global and regional gray matter density over 1 year.
Figure 2: Functional connectivity of NAc and insula.
Figure 3: mPFC-NAc functional connectivity predicts pain chronification.


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We thank all of the patients and healthy volunteers that participated in the study. The study was funded by the National Institute of Neurological Disorders and Stroke (NS35115). M.N.B. was funded by an anonymous foundation.

Author information




M.N.B. conducted the experiment, analyzed the data and prepared and wrote the manuscript. B.P. contributed to data collection and analysis. S.T. recruited subjects and conducted the experiment. K.M.H. contributed to data collection. L.H. performed data quality control. T.J.S. recruited subjects and edited the manuscript. H.L.F. wrote the manuscript. A.V.A. designed and supervised the experiment and wrote the manuscript.

Corresponding author

Correspondence to A Vania Apkarian.

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The authors declare no competing financial interests.

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Supplementary Figures 1–9 and Supplementary Tables 1–4 (PDF 2122 kb)

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Baliki, M., Petre, B., Torbey, S. et al. Corticostriatal functional connectivity predicts transition to chronic back pain. Nat Neurosci 15, 1117–1119 (2012).

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