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ORIGINAL RESEARCH article

Front. Pain Res.
Sec. Non-Pharmacological Treatment of Pain
Volume 5 - 2024 | doi: 10.3389/fpain.2024.1245235
This article is part of the Research Topic Insight in Non-Pharmacological Treatment of Pain – 2023 View all 5 articles

Does Practice Make Perfect? Functional Connectivity of the Salience Network and Somatosensory Network Predicts Response to Mind-Body Treatments for Fibromyalgia Running head: Prediction of treatment response in Fibromyalgia

Provisionally accepted
Sonia Medina Sonia Medina 1*Owen G. O'daly Owen G. O'daly 2Matthew A. Howard Matthew A. Howard 2Albert Feliu-Soler Albert Feliu-Soler 3Juan V. Luciano Juan V. Luciano 3
  • 1 University of Exeter, Exeter, United Kingdom
  • 2 King's College London, London, England, United Kingdom
  • 3 University Autonoma of Barcelona, Barcleona, Spain

The final, formatted version of the article will be published soon.

    Background. Mind-body treatments can improve coping mechanisms to deal with pain, improve the quality of life of patients with Fibromyalgia syndrome (FMS) and in some cases reduce perceived pain. However, responses are highly variable, the mechanisms underpinning them remain unclear and we lack reliable predictors of treatment response. We employed resting-state blood oxygen level dependent (rsBOLD) functional magnetic resonance imaging (fMRI) to examine changes in brain functional connectivity (FC) following mind-body treatment, that may relate to and predict pain relief. Methods. We recruited patients with FMS undergoing either mindfulness-based stress reduction (MBSR; n= 18) or a psychoeducational programme (FibroQoL; n= 22), and a treatment-as-usual FMS group (TAU; n= 18). We acquired rsBOLD data, alongside subjective pain, anxiety, depression, and catastrophizing measures prior to and following treatments. We examined behavioural changes and FC changes in the salience (SN) and sensorimotor (SMN) networks and performed regression analyses to identify predictors for treatment response. Results. MBSR and FibroQoL groups experienced significant reductions in pain catastrophizing. After treatment, FC of the sensorimotor cortex with the rest of the SMN became significantly reduced in the MBSR group compared to the TAU group. FC between the SN and the SMN at baseline was negatively correlated with pain reductions following MBSR, but positively correlated with pain reductions in the FibroQoL group. These results yielded large to very large effect sizes. Following MBSR, only for those patients with lower baseline SMN-SN FC, minutes of mindfulness practice was positively associated with clinical improvement (small to medium effect size). Conclusions. Different mind-body treatments are underpinned by discrete brain networks. Measures of functional interplay between SN and SMN have potential as predictors of mind-body treatment response in patients with FMS.

    Keywords: mindfulness, Fibromyalgia, rsBOLD, functional connectivity, brain biomarker

    Received: 23 Jun 2023; Accepted: 15 Aug 2024.

    Copyright: © 2024 Medina, O'daly, Howard, Feliu-Soler and Luciano. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Sonia Medina, University of Exeter, Exeter, United Kingdom

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