Striatal hypofunction as a neural correlate of mood alterations in chronic pain patients

Minhae Kim, Ishtiaq Mawla, Daniel S. Albrecht, Roee Admon, Angel Torrado-Carvajal, Courtney Bergan, Ekaterina Protsenko, Poornima Kumar, Robert R. Edwards, Atreyi Saha, Vitaly Napadow, Diego A. Pizzagalli, Marco L. Loggia

Research output: Contribution to journalArticlepeer-review


Background: Chronic pain and mood disorders share common neuroanatomical substrates involving disruption of the reward system. Although increase in negative affect (NA) and decrease in positive affect (PA) are well-known factors complicating the clinical presentation of chronic pain patients, our understanding of the mechanisms underlying the interaction between pain and PA/NA remains limited. Here, we used a validated task probing behavioral and neural responses to monetary rewards and losses in conjunction with functional magnetic resonance imaging (fMRI) to test the hypothesis that dysfunction of the striatum, a key mesolimbic structure involved in the encoding of motivational salience, relates to mood alterations comorbid with chronic pain. Methods: Twenty-eight chronic musculoskeletal pain patients (chronic low back pain, n=15; fibromyalgia, n=13) and 18 healthy controls underwent fMRI while performing the Monetary Incentive Delay (MID) task. Behavioral and neural responses were compared across groups and correlated against measures of depression (Beck Depression Inventory) and hedonic capacity (Snaith-Hamilton Pleasure Scale). Results: Compared to controls, patients demonstrated higher anhedonia and depression scores, and a dampening of striatal activation and incentive-related behavioral facilitation (reduction in reaction times) during reward and loss trials of the MID task (ps ​< ​0.05). In all participants, lower activation of the right striatum during reward trials was correlated with lower incentive-related behavioral facilitation and higher anhedonia scores (ps ​< ​0.05). Finally, among patients, lower bilateral striatal activation during loss trials was correlated with higher depression scores (ps ​< ​0.05). Conclusions: In chronic pain, PA reduction and NA increase are accompanied by striatal hypofunction as measured by the MID task.

Original languageEnglish
Article number116656
StatePublished - 1 May 2020

Bibliographical note

Publisher Copyright:
© 2020


  • Chronic pain
  • Functional magnetic resonance imaging (fMRI)
  • Monetary incentive delay task
  • Mood alteration
  • Reward circuitry
  • Striatal hypofunction
  • Corpus Striatum/diagnostic imaging
  • Depression/diagnostic imaging
  • Punishment
  • Fibromyalgia/diagnostic imaging
  • Anhedonia/physiology
  • Humans
  • Male
  • Magnetic Resonance Imaging
  • Chronic Pain/diagnostic imaging
  • Brain Mapping
  • Adult
  • Female
  • Delay Discounting/physiology
  • Reward
  • Low Back Pain/diagnostic imaging

ASJC Scopus subject areas

  • Neurology
  • Cognitive Neuroscience


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