Evidence map›Paper›PMID 26958466›Full record

Trial reportNeuroImage. Clinical2014

Unlearning chronic pain: A randomized controlled trial to investigate changes in intrinsic brain connectivity following Cognitive Behavioral Therapy.

Marina Shpaner, Clare Kelly, Greg Lieberman, Hayley Perelman, Marcia Davis, Francis J Keefe, Magdalena R Naylor

2 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in NeuroImage. Clinical, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 44 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03294148 nacompletednot on this mapstarted 2017, after this paper: background citation

Mind-body Treatments for Chronic Back Pain

TypeinterventionalSponsorUniversity of Colorado, BoulderRan2017 to 2019Enrolled151ConditionsChronic Pain, Back Pain Lower Back Chronic, Back Pain, LowArmsOpen-Label Placebo Treatment for Chronic Back Pain, Psychotherapy Treatment for Chronic Back Pain
NCT03634670 completednot on this mapstarted 2018, after this paper: background citation

The Influence of Interdisciplinary Multimodal Pain Therapy on Cerebral Connectivity in Chronic Pain Patients

TypeobservationalSponsorTechnical University of MunichRan2018 to 2020Enrolled41ConditionsChronic Pain, Interdisciplinary Multimodal Pain Therapy, Electroencephalography, Functional ConnectivityArmsInterdisciplinary multimodal pain therapy (IMPT)
3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Marina ShpanerPsychiatry, University of Vermont College of Medicine, Burlington, VT, USA.
Clare KellyPhyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, NYU Child Study Center, NYU Langone Medical Center, New York, NY, USA.
Greg LiebermanPsychiatry, University of Vermont College of Medicine, Burlington, VT, USA.
Hayley PerelmanPsychiatry, University of Vermont College of Medicine, Burlington, VT, USA.
Marcia DavisPsychiatry, University of Vermont College of Medicine, Burlington, VT, USA.
Francis J KeefeDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Magdalena R NaylorPsychiatry, University of Vermont College of Medicine, Burlington, VT, USA.

Funding

Can therapy alter CNS processing of chronic pain: A longitudinal studyR01AR059674 · NIAMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI NAYLOR, MAGDALENA R · 2010 to 2014
$3.0M
Using fMRI to evaluate CBT treatment response for patients with chronic painR21AR055716 · NIAMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI NAYLOR, MAGDALENA R · 2008 to 2009
$362k
NIAMS NIH HHS R01 AR059674NIAMS NIH HHS R01-AR059674NIAMS NIH HHS R21 AR055716NIAMS NIH HHS R21-AR055716
6 · The paper itself

Abstract

Chronic pain is a complex physiological and psychological phenomenon. Implicit learning mechanisms contribute to the development of chronic pain and to persistent changes in the central nervous system. We hypothesized that these central abnormalities can be remedied with Cognitive Behavioral Therapy (CBT). Specifically, since regions of the anterior Default Mode Network (DMN) are centrally involved in emotional regulation via connections with limbic regions, such as the amygdala, remediation of maladaptive behavioral and cognitive patterns as a result of CBT for chronic pain would manifest itself as a change in the intrinsic functional connectivity (iFC) between these prefrontal and limbic regions. Resting-state functional neuroimaging was performed in patients with chronic pain before and after 11-week CBT (n = 19), as well as a matched (ages 19-59, both sexes) active control group of patients who received educational materials (n = 19). Participants were randomized prior to the intervention. To investigate the differential impact of treatment on intrinsic functional connectivity (iFC), we compared pre-post differences in iFC between groups. In addition, we performed exploratory whole brain analyses of changes in fractional amplitude of low frequency fluctuations (fALFF). The course of CBT led to significant improvements in clinical measures of pain and self-efficacy for coping with chronic pain. Significant group differences in pre-post changes in both iFC and fALFF were correlated with clinical outcomes. Compared to control patients, iFC between the anterior DMN and the amygdala/periaqueductal gray decreased following CBT, whereas iFC between the basal ganglia network and the right secondary somatosensory cortex increased following CBT. CBT patients also had increased post-therapy fALFF in the bilateral posterior cingulate and the cerebellum. By delineating neuroplasticity associated with CBT-related improvements, these results add to mounting evidence that CBT is a valuable treatment option for chronic pain.

Indexed as

Adaptation, PsychologicalAdolescentAdultBrainChronic PainCognitive Behavioral TherapyEmotionsFemaleHumansImage Processing, Computer-AssistedMagnetic Resonance ImagingMaleMiddle AgedNerve NetPain ManagementPain MeasurementCBTChronic painDefault Mode NetworkFunctional connectivityFunctional MRI

Identifiers

PMID26958466
PMCPMC4749849

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.