Sustained pain is a major characteristic of clinical pain disorders, but it is difficult to assess in isolation from co-occurring cognitive and emotional features in patients. In this study, we developed a functional magnetic resonance imaging signature based on whole-brain functional connectivity that tracks experimentally induced tonic pain intensity and tested its sensitivity, specificity and generalizability to clinical pain across six studies (total n = 334). The signature displayed high sensitivity and specificity to tonic pain across three independent studies of orofacial tonic pain and aversive taste. It also predicted clinical pain severity and classified patients versus controls in two independent studies of clinical low back pain. Tonic and clinical pain showed similar network-level representations, particularly in somatomotor, frontoparietal and dorsal attention networks. These patterns were distinct from representations of experimental phasic pain. This study identified a brain biomarker for sustained pain with high potential for clinical translation.

持续性疼痛是临床疼痛障碍的主要特征，但很难与患者同时发生的认知和情绪特征隔离开来进行评估。在这项研究中，我们开发了一种基于全脑功能连接的功能性磁共振成像特征，该特征追踪实验诱导的强直性疼痛强度，并在六项研究中测试了其对临床疼痛的敏感性、特异性和普遍性（总共n= 334)。在三项关于口面部强直性疼痛和厌恶味觉的独立研究中，该特征显示出对强直性疼痛的高度敏感性和特异性。它还预测了临床疼痛的严重程度，并在两项独立的临床腰痛研究中对患者与对照组进行了分类。强直和临床疼痛表现出相似的网络级表现，特别是在躯体运动、额顶和背侧注意网络中。这些模式与实验性阶段性疼痛的表现不同。这项研究确定了一种具有很高临床转化潜力的持续疼痛的脑生物标志物。