Resting-state functional connectivity between the frontoparietal network and the default mode network is aberrantly increased in ankylosing spondylitis

Lower back pain comprises the majority of the disease burden of patients with ankylosing spondylitis (AS), while the alterations of the large-scale brain networks could be implicated in the neuropathophysiology of pain. The frontoparietal network (FPN) is known as a pain modulation hub, with key nodes dorsolateral prefrontal cortex (dlPFC) and ventrolateral prefrontal cortex (vlPFC) participating in the pain modulation and reappraisal process. In this study, we adopted the analytical approaches of independent component analysis (ICA) and seed-based correlation analysis (SCA) to examine the resting-state functional connectivity (rsFC) of the large-scale brain networks, notably FPN, between 82 AS patients and 61 healthy controls (HCs). We also investigated the correlation between the rsFC and the clinical measures of AS patients. Both ICA and SCA consistently showed that the rsFC between FPN and mPFC, a key node of the default mode network (DMN), was significantly increased in AS. In addition, SCA also identified a cluster at the right posterior lobe of cerebellum which exhibited increased rsFC with the posterior cingulate cortex, and the right lateral prefrontal cortex also showed increased rsFC with the right dlPFC. Correlation analysis showed that the rsFC between mPFC and the left anterior prefrontal cortex was significantly correlated with C-reactive protein in AS. The increased FPN-DMN connectivity could contribute to the neuropathophysiology of lower back pain in AS, with potential association with faulty pain modulation and reappraisal mechanisms facilitated by the FPN.