TYPE Original Research PUBLISHED 16 March 2023 DOI 10.3389/fnins.2023.1148176 OPEN ACCESS EDITED BY Hongxing Zhang, Xuzhou Medical University, China REVIEWED BY Junqin Ma, Southern Medical University, China Hongrui Zhan, The Fifth Affiliated Hospital of Sun Yat-sen University, China *CORRESPONDENCE Selma Delgado-Gallén selmadelgado@guttmann.com SPECIALTY SECTION This article was submitted to Perception Science, a section of the journal Frontiers in Neuroscience RECEIVED 19 January 2023 ACCEPTED 28 February 2023 PUBLISHED 16 March 2023 CITATION Delgado-Gallén S, Soler MD, Cabello-Toscano M, Abellaneda-Pérez K, Solana-Sánchez J, España-Irla G, Roca-Ventura A, Bartrés-Faz D, Tormos JM, Pascual-Leone A and Cattaneo G (2023) Brain system segregation and pain catastrophizing in chronic pain progression. Front. Neurosci. 17:1148176. doi: 10.3389/fnins.2023.1148176 COPYRIGHT © 2023 Delgado-Gallén, Soler, Cabello-Toscano, Abellaneda-Pérez, Solana-Sánchez, España-Irla, Roca-Ventura, Bartrés-Faz, Tormos, Pascual-Leone and Cattaneo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Brain system segregation and pain catastrophizing in chronic pain progression Selma Delgado-Gallén 1,2,3 *, MD Soler 1,2,3 , María Cabello-Toscano 1,4,5 , Kilian Abellaneda-Pérez 1,2,3 , Javier Solana-Sánchez 1,2,3 , Goretti España-Irla 1,2,3 , Alba Roca-Ventura 1,4,5 , David Bartrés-Faz 1,4,5 , Josep M. Tormos 1,6 , Alvaro Pascual-Leone 1,7,8 and Gabriele Cattaneo 1,2,3 1 Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain, 2 Departament de Medicina, Facultat de Medicina, Universitat Autónoma de Barcelona, Bellaterra, Spain, 3 Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Barcelona, Spain, 4 Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain, 5 Departament de Medicina, Facultat de Medicina i Ciéncies de la Salut, Universitat de Barcelona, Barcelona, Spain, 6 Centro de Investigación Traslacional San Alberto Magno, Facultad de Medicina y Ciencias de la Salud, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain, 7 Hinda and Arthur Marcus Institute for Aging Research and Center for Memory Health, Hebrew SeniorLife, Boston, MA, United States, 8 Department of Neurology, Harvard Medical School, Boston, MA, United States Pain processing involves emotional and cognitive factors that can modify pain perception. Increasing evidence suggests that pain catastrophizing (PC) is implicated, through pain-related self-thoughts, in the maladaptive plastic changes related to the maintenance of chronic pain (CP). Functional magnetic resonance imaging (fMRI) studies have shown an association between CP and two main networks: default mode (DMN) and dorsoattentional (DAN). Brain system segregation degree (SyS), an fMRI framework used to quantify the extent to which functional networks are segregated from each other, is associated with cognitive abilities in both healthy individuals and neurological patients. We hypothesized that individuals suffering from CP would show worst health- related status compared to healthy individuals and that, within CP individuals, longitudinal changes in pain experience (pain intensity and affective interference), could be predicted by SyS and PC subdomains (rumination, magnification, and helplessness). To assess the longitudinal progression of CP, two pain surveys were taken before and after an in-person assessment (physical evaluation and fMRI). We first compared the sociodemographic, health-related, and SyS data in the whole sample (no pain and pain groups). Secondly, we ran linear regression and a moderation model only in the pain group, to see the predictive and moderator values of PC and SyS in pain progression. From our sample of 347 individuals (mean age = 53.84, 55.2% women), 133 responded to having CP, and 214 denied having CP. When comparing groups, results showed significant differences in health-related questionnaires, but no differences in SyS. Within the pain group, helplessness (β = 0.325; p = 0.003), higher DMN (β = 0.193; p = 0.037), and lower DAN segregation (β = 0.215; p = 0.014) were strongly associated with a worsening in pain experience over time. Moreover, helplessness moderated the association between DMN segregation and pain experience progression (p = 0.003). Our findings indicate that the efficient functioning of these networks Frontiers in Neuroscience 01 frontiersin.org