Pain during adolescence is common and is associated with future pain chronicity and mental health in adulthood. However, understanding of the neural underpinnings of chronic pain has largely come from studies in adults, with recent studies in adolescents suggesting potentially unique neural features during this vulnerable developmental period. In addition to alterations in the pain network, resting state functional magnetic resonance imaging studies in adults suggest alterations in the default mode network (DMN), involved in internally-driven, self-referential thought, may underlie chronic pain; however, these findings have yet to be examined in adolescents. The current study sought to investigate associations between pain frequency and intensity, and disruptions in DMN connectivity, in adolescents. Adolescents (ages 12–20) with varying levels of pain frequency and intensity, recruited from a pediatric pain clinic and the local community (n = 86; 60% female), underwent resting state functional magnetic resonance imaging. Using independent components analysis, the DMN was identified and correlated voxel-wise to assess associations between pain frequency and intensity and DMN connectivity. Findings revealed that adolescents with greater pain frequency demonstrated greater DMN to superior frontal gyrus connectivity, while adolescents with greater pain intensity demonstrated lesser DMN to cerebellum (lobule VIII) connectivity, during rest. These findings suggest that increasing levels of pain are associated with potential desegregation of the DMN and the prefrontal cortex, important for cognitive control, and with novel patterns of DMN to cerebellum connectivity. These findings may prove beneficial as neurobiological targets for future treatment efforts in adolescents.

青春期疼痛很常见，并与成年后的慢性疼痛慢性和心理健康有关。但是，对慢性疼痛的神经基础的理解主要来自成年人的研究，而最近在青少年中的研究表明，在这种脆弱的发育期中潜在的独特神经特征。除了对疼痛网络的改变外，成年人的静息状态功能磁共振成像研究表明，默认模式网络（DMN）的改变可能与慢性疼痛有关，而默认模式网络的改变与内部驱动的自我参照思维有关。然而，这些发现尚未在青少年中进行检查。当前的研究试图调查青少年疼痛频率和强度与DMN连接中断之间的关联。从儿童疼痛诊所和当地社区（n = 86； 60％的女性）招募的疼痛频率和强度不同的青少年（12至20岁）经历了静息状态功能磁共振成像。使用独立的成分分析，可以识别DMN并按体素进行关联，以评估疼痛频率和强度与DMN连通性之间的关联。研究结果表明，在休息期间，疼痛频率较高的青少年表现出较高的额叶回与上额额回连接性，而疼痛强度较高的青少年表现出较低的DMN与小脑（小叶VIII）连接性。这些发现表明，疼痛的加剧与DMN和前额叶皮层的潜在分离有关，这对于认知控制，并具有DMN与小脑连接的新颖模式。这些发现可能被证明是未来青少年治疗工作的神经生物学靶标。