Does Practice Make Perfect? Functional Connectivity of the Salience Network and Somatosensory Network Predicts Response to Mind-Body Treatments for Fibromyalgia

Abstract

Abstract Mind-body treatments can improve coping mechanisms, and occasionally perceived pain, in individuals with Fibromyalgia syndrome (FMS). However, their mechanisms-of-action remain unclear and predictors of treatment response are lacking. We employed resting-state blood oxygen level dependent (rsBOLD) functional magnetic resonance imaging (fMRI) to address this need by examining changes in brain functional connectivity (FC) following mind-body treatment. Patients with FMS underwent either mindfulness-based stress reduction (MBSR), a psychoeducational programme (FibroQoL), or treatment-as-usual (TAU). We acquired rsBOLD data, alongside subjective pain, anxiety, depression, and catastrophizing measures prior to and following treatments. We examined behavioural and FC changes in the salience (SN) and sensorimotor (SMN) networks, performing regression analyses to identify predictors for treatment response. MBSR and FibroQoL groups experienced significant reductions in pain catastrophizing. FC between the SN and the SMN at baseline correlated negatively with pain reductions following MBSR, but positively correlated with pain reductions in the FibroQoL group. Minutes of mindfulness practice was positively associated with clinical improvement but only for patients with lower baseline SN FC with primary somatosensory cortex. Different mind-body treatments are underpinned by distinct effects on discrete brain networks. Measures of functional interplay between SN and SMN have potential as predictors of mind-body treatment response in patients with FMS.