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The brain of a chronic pain patient is not simply a healthy brain processing pain information, but rather is altered by the persistent pain in a manner reminiscent of other neurological conditions associated with cognitive impairments.

“Recent studies have demonstrated that chronic pain harms cortical areas unrelated to pain, but whether these structural impairments and behavioral deficits are connected by a single mechanism is as of yet unknown. Here we propose that long-term pain alters the functional connectivity of cortical regions known to be active at rest, i.e., the components of the “default mode network” (DMN).” …

“Studying with fMRI a group of chronic back pain (CBP) patients and healthy controls while executing a simple visual attention task, we discovered that CBP patients, despite performing the task equally well as controls, displayed reduced deactivation in several key DMN regions. These findings demonstrate that chronic pain has a widespread impact on overall brain function, and suggest that disruptions of the DMN may underlie the cognitive and behavioral impairments accompanying chronic pain.

Beyond Feeling: Chronic Pain Hurts the Brain, Disrupting the Default-Mode Network Dynamics — Baliki et al. 28 (6): 1398 — Journal of Neuroscience