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Altered resting state attentional networks in diabetic neuropathic pain
  1. F Cauda1,2,
  2. F D'Agata1,2,3,
  3. K Sacco1,2,
  4. S Duca1,
  5. D Cocito3,
  6. I Paolasso3,
  7. G Isoardo4,
  8. G Geminiani1
  1. 1CCS fMRI, Koelliker Hospital, Turin, Italy
  2. 2Department of Psychology, University of Turin, Turin, Italy
  3. 3Department of Neuroscience, AOU San Giovanni Battista, Turin, Italy
  4. 4Neurophysiology Unit, Department of Neurosurgery, Azienda Sanitaria CTO, Turin, Italy
  1. Correspondence to Dr Cauda Franco, Dipartimento di Psicologia, Via Po 14, Turin 10123, Italy; franco.cauda{at}


Background Chronic pain can be considered as a highly salient stimulus that continuously taxes the attentional and salience processing networks, thus interfering with cognitive abilities and, more specifically, consuming attentional resources. The aim of the paper was to explore whether and how diabetic neuropathic pain (NP) affects attentional networks.

Methods The authors sought to achieve this by investigating resting state functional connectivity (rsFC) in diabetic NP patients and comparing it with that of matched healthy controls.

Results NP patients showed a widespread reduction in connectivity in both the dorsal and ventral attentional networks, as well as in the dorsal anterior cingulated cortex (ACC), typically implicated in salience processing. The authors also found a generalised reduction in the length of functional connections in the NP group: in all the examined networks, the Euclidean distance between connected voxels was significantly shorter in patients than in controls.

Conclusion In diabetic NP, a parieto-fronto-cingulate network controlling attention to external stimuli is impaired. In line with previous studies, chronic pain can disrupt the synchrony of a common pool of brain areas, involved in self-monitoring, pain processing and salience detection.

  • Neuropathic pain
  • resting state
  • functional connectivity
  • attentional networks
  • functional MRI (fMRI)
  • attention
  • functional imaging
  • pain

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  • Funding This research was supported by the Italian Ministry of Education, University and Research (MIUR), PRIN project 2008, prot. 2007P2CWAZ.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Ethics Committee Department of Psychology, University of Turin.

  • Provenance and peer review Not commissioned; externally peer reviewed.