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Licensed Unlicensed Requires Authentication Published by De Gruyter August 10, 2021

Examining resting-state functional connectivity in key hubs of the default mode network in chronic low back pain

  • Sin Ki Ng EMAIL logo , Donna M. Urquhart , Paul B. Fitzgerald , Flavia M. Cicuttini , Melissa Kirkovski , Jerome J. Maller , Peter G. Enticott , Susan L. Rossell and Bernadette M. Fitzgibbon



Changes in brain connectivity have been observed within the default mode network (DMN) in chronic low back pain (CLBP), however the extent of these disruptions and how they may be related to CLBP requires further examination. While studies using seed-based analysis have found disrupted functional connectivity in the medial prefrontal cortex (mPFC), a major hub of the DMN, limited studies have investigated other equally important hubs, such as the posterior cingulate cortex (PCC) in CLBP.


This preliminary study comprised 12 individuals with CLBP and 12 healthy controls who completed a resting-state functional magnetic resonance imaging (fMRI) scan. The mPFC and PCC were used as seeds to assess functional connectivity.


Both groups displayed similar patterns of DMN connectivity, however group comparisons showed that CLBP group had reduced connectivity between the PCC and angular gyrus compared to healthy controls. An exploratory analysis examined whether the alterations observed in mPFC and PCC connectivity were related to pain catastrophizing in CLBP, but no significant associations were observed.


These results may suggest alterations in the PCC are apparent in CLBP, however, the impact and functional role of these disruptions require further investigation.

Corresponding author: Dr. Sin Ki Ng, BBNSc (Hons), Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Central Clinical School Monash University, Melbourne, VIC, Australia; and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004 Australia, Phone: +61 3 9076 6564, Fax: +61 3 9076 6588, E-mail:

Funding source: National Health and Medical Research Council (NHMRC) 10.13039/501100000925

Award Identifier / Grant number: Clinical Level 2 #1142809

Award Identifier / Grant number: #1070073

Award Identifier / Grant number: 1078567

Award Identifier / Grant number: 1154651

Funding source: Australian Research Council (ARC) 10.13039/501100000923

Award Identifier / Grant number: FT160100077

  1. Research funding: DMU and BMF are recipients of a National Health and Medical Research Council (NHMRC) Career Development Fellowship (Clinical Level 2 #1142809) and an NHMRC Early Career Fellowship (#1070073) respectively. PBF was supported by a Practitioner Fellowship grant from National Health and Medical Research Council (NHMRC) (1078567). PGE is supported by a Future Fellowship from the Australian Research Council (ARC) (FT160100077). SLR holds a Senior Research Fellowship from National Health and Medical Research Council (NHMRC) (1154651).

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: PBF has received equipment for research from Medtronic, MagVenture A/S and Brainsway Ltd. He is on scientific advisory boards for Bionomics Ltd and LivaNova and is a founder of TMS Clinics Australia. There are no other potential conflicts of interest.

  4. Informed consent: Informed consent has been obtained from all participants included in this study.

  5. Ethical approval: This study was approved by the Monash University (CF12/2213–2012001190) and Alfred Health Human Research Ethics Committees (243/12).


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Received: 2020-12-16
Accepted: 2021-04-29
Published Online: 2021-08-10
Published in Print: 2021-10-26

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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