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Inefficient default mode network hyperconnectivity characterizes chronic low back-related leg pains: a static and dynamic functional MRI study.

Ziwei Yang, Xiao Liang, Yuqi Ji, Yao Wang, Yong Zhang, Fuqing Zhou

Brain Imaging and Behavior February 28, 2026 DOI: 10.1007/s11682-026-01093-2 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Observational case-control study Peer reviewed
Sample size 101
Population Adults with low back-related leg pain (19 acute, 31 chronic) and 51 healthy controls
Measures LANSS
Topics Default mode network
Keywords Leg Neural pathways Humans Low back pain Magnetic resonance imaging Brain mapping Adult Middle aged Female Chronic pain Graph theory analysis Static/dynamic functional connectivity
Key findings Chronic low back-related leg pain was associated with reduced global and nodal efficiency and increased static functional connectivity between the DMN core and medial temporal lobe subsystems, with static node topology changes correlating with pain intensity. Acute pain showed reduced dynamic functional connectivity variability between these subsystems, which predicted neurological deficits on the LANSS. The authors argue chronic pain reflects inefficient DMN hyperconnectivity while acute pain disrupts DMN temporal flexibility.

Abstract

Pain-induced reorganization of the default mode network (DMN) exhibits distinct temporal signatures in the acute and chronic stages, yet the mechanistic interplay between static/dynamic network topology and pain chronicity remains unclear. In this study, we utilized both static and dynamic graph theory analyses to characterize DMN reconfiguration in 50 patients with low back-related leg pain (LBLP)--comprising 19 acute (aLBLP) and 31 chronic (cLBLP)--compared to 51 healthy controls. Chronic pain patients exhibited reduced global and nodal efficiency, accompanied by increased static functional connectivity (sFC) between the core and medial temporal lobe (MTL) subsystems. In contrast, acute pain patients demonstrated decreased temporal variability in dynamic functional connectivity (dFC), particularly between the core and MTL subsystems. Importantly, the alterations of static node topology properties in cLBLP correlated with pain intensity, whereas reduced dFC variability in aLBLP was predictive of neurological deficits, as assessed by the neurological assessments (LANSS). These findings suggest that chronic LBLP is associated with a paradoxical DMN state–inefficient hyperconnectivity–whereas acute pain disrupts temporal flexibility of DMN dynamics. This study advances our understanding of the dynamic interplay between DMN topology and pain chronicity, highlighting potential biomarkers for pain progression and neuroplasticity.

Comparable studies

Other observational and cohort studies on default mode network, most cited first.

Study Year Design Participants
A default mode of brain function Normal adult human brain 2001 Observational study
Resting-State Functional Connectivity Reflects Structural Connectivity in the Default Mode Network Healthy subjects 2008 Observational cohort
Meditation experience is associated with increased cortical thickness Participants with extensive Insight meditation experience and matched controls 2005 Observational cohort n = 20
Meditation experience is associated with differences in default mode network activity and connectivity Experienced meditators and matched meditation-naive controls 2011 Observational cohort
The precuneus/posterior cingulate cortex plays a pivotal role in the default mode network: Evidence from a partial correlation network analysis Healthy subjects 2008 Observational study

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Default mode network Neuroplasticity