Dysregulated anterior insula reactivity as robust functional biomarker for chronic pain—Meta-analytic evidence from neuroimaging studies

Ferraro, Stefania; Klugah-Brown, Benjamin; Tench, Christopher R.; Yao, Shuxia; Nigri, Anna; Demichelis, Greta; Pinardi, Chiara; Bruzzone, Maria Grazia; Becker, Benjamin

Abstract

Neurobiological pain models propose that chronic pain is accompanied by neurofunctional changes that mediate pain processing dysfunctions. In contrast, meta-analyses of neuroimaging studies in chronic pain conditions have not revealed convergent evidence for robust alterations during experimental pain induction. Against this background, the present neuroimaging meta-analysis combined three different meta-analytic approaches with stringent study selection criteria for case–control functional magnetic resonance imaging experiments during acute pain processing with a focus on chronic pain disorders. Convergent neurofunctional dysregulations in chronic pain patients were observed in the left anterior insula cortex. Seed-based resting-state functional connectivity based on a large publicly available dataset combined with a meta-analytic task-based approach identified the anterior insular region as a key node of an extended bilateral insula-fronto-cingular network, resembling the salience network. Moreover, the meta-analytic decoding showed that this region presents a high probability to be specifically activated during pain-related processes, although we cannot exclude an involvement in autonomic processes. Together, the present findings indicate that dysregulated left anterior insular activity represents a robust neurofunctional maladaptation and potential treatment target in chronic pain disorders.

Citation

Ferraro, S., Klugah-Brown, B., Tench, C. R., Yao, S., Nigri, A., Demichelis, G., …Becker, B. (2022). Dysregulated anterior insula reactivity as robust functional biomarker for chronic pain—Meta-analytic evidence from neuroimaging studies. Human Brain Mapping, 43(3), 998-1010. https://doi.org/10.1002/hbm.25702

• Journal Article Type: Article
• Acceptance Date: Oct 19, 2021
• Online Publication Date: Nov 3, 2021
• Publication Date: Feb 15, 2022
• Deposit Date: Mar 15, 2022
• Publicly Available Date: Mar 18, 2022
• Journal: Human Brain Mapping
• Print ISSN: 1065-9471
• Electronic ISSN: 1097-0193
• Peer Reviewed: Peer Reviewed
• Volume: 43
• Issue: 3
• Pages: 998-1010
• DOI: https://doi.org/10.1002/hbm.25702
• Public URL: https://nottingham-repository.worktribe.com/output/7605128
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1002/hbm.25702