ArticlePain2018
Altered connectivity of the right anterior insula drives the pain connectome changes in chronic knee osteoarthritis.
Article in Pain, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 3 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
61 citing papers in PubMed, 3 syntheses or guidelines pooled it, 109 citations in OpenAlex.
- Neurobiology of osteoarthritis: a systematic review and activation likelihood estimation meta-analysis.Scientific reports · 2023Pooled it
- Effects of Chronic Pain Treatment on Altered Functional and Metabolic Activities in the Brain: A Systematic Review and Meta-Analysis of Functional Neuroimaging Studies.Frontiers in neuroscience · 2021Pooled it
- Pooled it
- Effects of Tai Chi combined with transcranial direct current stimulation on pain in knee osteoarthritis: a randomized controlled neuroimaging trial.BMC medicine · 2026Trial
- Effects of transcranial direct current stimulation combined with acupuncture therapy on brain network functional connectivity in patients with knee osteoarthritis: a single-center randomized controlled trial.Journal of neuroengineering and rehabilitation · 2025Trial
- Closed-Loop Infraslow Brain-Computer Interface can Modulate Cortical Activity and Connectivity in Individuals With Chronic Painful Knee Osteoarthritis: A Secondary Analysis of a Randomized Placebo-Controlled Clinical Trial.Clinical EEG and neuroscience · 2025Trial
- Trial
- Dynamic reconfiguration of directed effective connectivity between attention networks and the default mode network in knee osteoarthritis: a combined resting-state and non-noxious thermal stimulation functional magnetic resonance imaging study.The Korean journal of pain · 2026Article
- The hijacked insula: A stratified model of affective touch modulation in chronic pain.Journal of neuropsychology · 2026Review
- Longitudinal co-activation pattern analysis of menstrual cycle-related brain dynamics in primary dysmenorrhea.iScience · 2026Article
- Systemic implications of osteoarthritis: from local degeneration to systemic metabolic Dysregulation.Journal of translational medicine · 2026Review
- Brain sensory network activity underlies reduced nociceptive initiated and nociplastic pain via acupuncture in fibromyalgia.Communications medicine · 2026Article
- CT-based subchondral bone microstructural analysis in knee osteoarthritis via MR-guided distillation learning.Frontiers in radiology · 2026Article
- Neurofeedback Training for Managing Neuropathic Pain-Like Features in Chronic Musculoskeletal Pain: Protocol for an Open-Label Pilot Feasibility Clinical Trial.JMIR research protocols · 2025Article
- Brain Sensory Network Activity Underlies Reduced Nociceptive-Initiated and Nociplastic Pain via Acupuncture in Fibromyalgia.Research square · 2025Article
- Brain functional imaging contributions in osteoarthritis-related pain: A viewpoint.Osteoarthritis and cartilage open · 2025Article
- The importance of central sensitization for clinical trials of disease modifying osteoarthritis drugs (DMOADs).Osteoarthritis imaging · 2025Article
- Effect of Acupuncture on Functional Connectivity of the Limbic Network in Patients with Knee Osteoarthritis: A Resting State Functional Magnetic Resonance Imaging Study.Journal of pain research · 2025Article
- Advances in Neuroimaging of Breast Cancer Pain: An Overview.Journal of pain research · 2025Review
- Abnormal thalamocortical network dynamics in patients with migraine and its relationship with electroacupuncture treatment response.Brain imaging and behavior · 2024Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Resting-state functional connectivity (FC) has proven a powerful approach to understand the neural underpinnings of chronic pain, reporting altered connectivity in 3 main networks: the default mode network (DMN), central executive network, and the salience network (SN). The interrelation and possible mechanisms of these changes are less well understood in chronic pain. Based on emerging evidence of its role to drive switches between network states, the right anterior insula (rAI, an SN hub) may play a dominant role in network connectivity changes underpinning chronic pain. To test this hypothesis, we used seed-based resting-state FC analysis including dynamic and effective connectivity metrics in 25 people with chronic osteoarthritis (OA) pain and 19 matched healthy volunteers. Compared with controls, participants with painful knee OA presented with increased anticorrelation between the rAI (SN) and DMN regions. Also, the left dorsal prefrontal cortex (central executive network hub) showed more negative FC with the right temporal gyrus. Granger causality analysis revealed increased negative influence of the rAI on the posterior cingulate (DMN) in patients with OA in line with the observed enhanced anticorrelation. Moreover, dynamic FC was lower in the DMN of patients and thus more similar to temporal dynamics of the SN. Together, these findings evidence a widespread network disruption in patients with persistent OA pain and point toward a driving role of the rAI.
Indexed as
Identifiers
What OpenQuestion holds
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.