A dynamic network perspective of chronic pain

We briefly summarize recent advances regarding brain functional representation of chronic pain, reorganization of resting state brain activity, and of brain anatomy with chronic pain. Based on these observations and recent theoretical advances regarding network architecture properties, we develop a general concept of the dynamic interplay between anatomy and function as the brain progresses into persistent pain, and outline the role of mesolimbic learning mechanisms that are likely involved in maintenance of chronic pain.

► We review literature describing the dynamic interaction between brain networks in chronic pain.
► Chronic pain reflects a shift from nociceptive to mesolimbic circuitry over time.
► Plasticity of hierarchically organized networks underlies brain reorganization with persistent pain.
► Unique conditions reflect distinct patterns of network reorganization.
► Neuroplastic changes associated with emotional pain learning drive changes in brain structure and function.