Effect sizes and test-retest reliability of the fMRI-based neurologic pain signature

Xiaochun Han, Yoni K. Ashar, Philip Kragel, Bogdan Petre, Victoria Schelkun, Lauren Y. Atlas, Luke J. Chang, Marieke Jepma, Leonie Koban, Elizabeth A.Reynolds Losin, Mathieu Roy, Choong Wan Woo, Tor D. Wager

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17 Scopus citations


Identifying biomarkers that predict mental states with large effect sizes and high test-retest reliability is a growing priority for fMRI research. We examined a well-established multivariate brain measure that tracks pain induced by nociceptive input, the Neurologic Pain Signature (NPS). In N = 295 participants across eight studies, NPS responses showed a very large effect size in predicting within-person single-trial pain reports (d = 1.45) and medium effect size in predicting individual differences in pain reports (d = 0.49). The NPS showed excellent short-term (within-day) test-retest reliability (ICC = 0.84, with average 69.5 trials/person). Reliability scaled with the number of trials within-person, with ≥60 trials required for excellent test-retest reliability. Reliability was tested in two additional studies across 5-day (N = 29, ICC = 0.74, 30 trials/person) and 1-month (N = 40, ICC = 0.46, 5 trials/person) test-retest intervals. The combination of strong within-person correlations and only modest between-person correlations between the NPS and pain reports indicate that the two measures have different sources of between-person variance. The NPS is not a surrogate for individual differences in pain reports but can serve as a reliable measure of pain-related physiology and mechanistic target for interventions.

Original languageEnglish (US)
Article number118844
StatePublished - Feb 15 2022

All Science Journal Classification (ASJC) codes

  • Neurology
  • Cognitive Neuroscience

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