• Lino Becerra, Simona Sava, Laura E Simons, Athena M Drosos, Navil Sethna, Charles Berde, Alyssa A Lebel, and David Borsook.
• Pain/Analgesia Imaging Neuroscience (P.A.I.N.) Group, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA ; Department of Anesthesiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA ; Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA 02115, USA.
• Neuroimage Clin. 2014 Jan 1;6:347-69.

AbstractPediatric complex regional pain syndrome (P-CRPS) offers a unique model of chronic neuropathic pain as it either resolves spontaneously or through therapeutic interventions in most patients. Here we evaluated brain changes in well-characterized children and adolescents with P-CRPS by measuring resting state networks before and following a brief (median = 3 weeks) but intensive physical and psychological treatment program, and compared them to matched healthy controls. Differences in intrinsic brain networks were observed in P-CRPS compared to controls before treatment (disease state) with the most prominent differences in the fronto-parietal, salience, default mode, central executive, and sensorimotor networks. Following treatment, behavioral measures demonstrated a reduction of symptoms and improvement of physical state (pain levels and motor functioning). Correlation of network connectivities with spontaneous pain measures pre- and post-treatment indicated concomitant reductions in connectivity in salience, central executive, default mode and sensorimotor networks (treatment effects). These results suggest a rapid alteration in global brain networks with treatment and provide a venue to assess brain changes in CRPS pre- and post-treatment, and to evaluate therapeutic effects.

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