Dynamics of brain function in chronic pain patients assessed by microstate analysis of resting-state electroencephalography

Chronic pain is a highly prevalent and severely disabling disease, which is associated with substantial changes of brain function. Such changes have mostly been observed when analyzing static measures of brain activity during the resting-state. However, brain activity varies over time and it is increasingly recognized that the temporal dynamics of brain activity provide behaviorally relevant information in different neuropsychiatric disorders. Here, we therefore investigated whether the temporal dynamics of brain function are altered in chronic pain. To this end, we applied microstate analysis to eyes-open and eyes-closed resting-state electroencephalography (EEG) data of 101 patients suffering from chronic pain and 88 age- and gender-matched healthy controls. Microstate analysis describes EEG activity as a sequence of a limited number of topographies termed microstates, which remain stable for tens of milliseconds. Our results revealed that sequences of 5 microstates, labelled with the letters A to E, described resting-state brain activity in both groups and conditions. Bayesian analysis of the temporal characteristics of microstates revealed that microstate D has a less predominant role in patients than in healthy participants. This difference was consistently found in eyes-open and eyes-closed EEG recordings. No evidence for differences in other microstates was found. As microstate D has been previously related to attentional networks and functions, abnormalities of microstate D might relate to dysfunctional attentional processes in chronic pain. These findings add to the understanding of the pathophysiology of chronic pain and might eventually contribute to the development of an EEG-based biomarker of chronic pain.