title: Functional connectivity of the default mode network and its association with pain networks in irritable bowel patients assessed via lidocaine treatment.
abstract: The default mode network (DMN), a group of brain regions implicated in passive thought processes, has been proposed as a potentially informative neural marker to aid in novel treatment development. However, the DMN's internal connectivity and its temporal relationship (ie, functional network connectivity) with pain-related neural networks in chronic pain conditions is poorly understood, as is the DMN's sensitivity to analgesic effects. The current study assessed how DMN functional connectivity and its temporal association with 3 pain-related networks changed after rectal lidocaine treatment in irritable bowel syndrome patients. Eleven females with irritable bowel syndrome underwent a rectal balloon distension paradigm during functional magnetic resonance imaging in 2 conditions: natural history (ie, baseline) and lidocaine. Results showed increased DMN connectivity with pain-related regions during natural history and increased within-network connectivity of DMN structures under lidocaine. Further, there was a significantly greater lag time between 2 of the pain networks, those involved in cognitive and in affective pain processes, comparing lidocaine to natural history. These findings suggest that 1) DMN plasticity is sensitive to analgesic effects, and 2) reduced pain ratings via analgesia reflect DMN connectivity more similar to pain-free individuals. Findings show potential implications of this network as an approach for understanding clinical pain management techniques.
  
  
  CONCLUSIONS
  This study shows that lidocaine, a peripheral analgesic, significantly altered DMN connectivity and affected its relationship with pain-related networks. These findings suggest that the DMN, which is hypothesized to represent non-goal-oriented activity, is sensitive to analgesic effects and could be useful to understand pain treatment mechanisms.
authors.affiliation: Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida.
authors.forename: Janelle E
authors.initials: JE
authors.lastname: Letzen
authors.forename: Jason G
authors.initials: JG
authors.lastname: Craggs
authors.forename: William M
authors.initials: WM
authors.lastname: Perlstein
authors.forename: Donald D
authors.initials: DD
authors.lastname: Price
authors.forename: Michael E
authors.initials: ME
authors.lastname: Robinson
mesh_terms: D000285:Administration, Rectal; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D003627:Data Interpretation, Statistical; D005260:Female; D007839:Functional Laterality; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy* / Q000503:physiopathology* / Q000523:psychology; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D009415:Nerve Net / Q000503:physiopathology*; D009434:Neural Pathways / Q000503:physiopathology*; D010146:Pain / Q000503:physiopathology*; D010147:Pain Measurement; D010812:Physical Stimulation; D025341:Principal Component Analysis; D059265:Visceral Pain / Q000503:physiopathology / Q000523:psychology
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine
keywords: Default mode network; fMRI; functional network connectivity; irritable bowel syndrome; lidocaine