Pain-Evoked Reorganization in Functional Brain Networks

Weihao Zheng, Choong Wan Woo, Zhijun Yao, Pavel Goldstein, Lauren Y. Atlas, Mathieu Roy, Liane Schmidt, Anjali Krishnan, Marieke Jepma, Bin Hu, Tor D. Wager

Research output: Contribution to journalArticlepeer-review


Recent studies indicate that a significant reorganization of cerebral networks may occur in patients with chronic pain, but how immediate pain experience influences the organization of large-scale functional networks is not yet well characterized. To investigate this question, we used functional magnetic resonance imaging in 106 participants experiencing both noxious and innocuous heat. Painful stimulation caused network-level reorganization of cerebral connectivity that differed substantially from organization during innocuous stimulation and standard resting-state networks. Noxious stimuli increased somatosensory network connectivity with (a) frontoparietal networks involved in context representation, (b) "ventral attention network" regions involved in motivated action selection, and (c) basal ganglia and brainstem regions. This resulted in reduced "small-worldness," modularity (fewer networks), and global network efficiency and in the emergence of an integrated "pain supersystem" (PS) whose activity predicted individual differences in pain sensitivity across 5 participant cohorts. Network hubs were reorganized ("hub disruption") so that more hubs were localized in PS, and there was a shift from "connector" hubs linking disparate networks to "provincial" hubs connecting regions within PS. Our findings suggest that pain reorganizes the network structure of large-scale brain systems. These changes may prioritize responses to painful events and provide nociceptive systems privileged access to central control of cognition and action during pain.

Original languageEnglish
Pages (from-to)2804-2822
Number of pages19
JournalCerebral Cortex
Issue number5
StatePublished - 14 May 2020

Bibliographical note

Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press. All rights reserved.


  • functional network
  • hub disruption
  • immediate pain
  • inter-system connectivity
  • reorganization

ASJC Scopus subject areas

  • Cellular and Molecular Neuroscience
  • Cognitive Neuroscience


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