Alterations in dynamic regional homogeneity and functional connectivity in lung cancer patients with bone metastasis pain.

[BACKGROUND] Although previous neuroimaging studies have characterized static brain activity in bone metastasis pain (BMP), its dynamic functional properties remain largely unexplored. This study aimed to investigate the dynamic brain activity in BMP patients.

[METHODS] We analyzed dynamic regional homogeneity (dReHo) and dynamic functional connectivity (dFC) in 50 right-handed lung cancer patients with BMP(+), 36 without BMP(-), and 32 healthy controls (HCs). Spearman's correlation was used to evaluate associations with clinical variables.

[RESULTS] Compared to BMP(-) patients, BMP(+) patients exhibited increased dReHo variability in the right putamen, fusiform gyrus, left middle occipital gyrus (MOG), and left cerebellar lobule VIII (cerebellum_8_L). Relative to HCs, BMP(+) patients showed increased dReHo in the cerebellum_8_L and decreased dReHo in the left anterior cingulate cortex, right inferior temporal gyrus, and frontal lobe. BMP(-) patients displayed decreased dReHo in the right rolandic operculum and putamen compared to HCs. In BMP(+) patients, dReHo variability in the left MOG was positively correlated with pain intensity, while dReHo variability in the right fusiform gyrus was negatively associated with anxiety. Enhanced dFC was observed between the right fusiform/left MOG and cerebellar subregions in BMP(+) compared to BMP(-) patients.

[CONCLUSIONS] This study demonstrates abnormal dynamic brain activity within visual, affective, and sensorimotor networks in patients with BMP. These findings suggest that dReHo/dFC variability may serve as a neuroimaging biomarker for BMP diagnosis and disease monitoring. Furthermore, they provide new insights into the neurophysiological mechanisms of BMP and identify promising targets for neuromodulation-based therapeutic interventions.