Prospective Administration of Anti-NGF Treatment Effectively Suppresses Functional Connectivity Alterations Following Cancer-Induced Bone Pain in Mice

Abstract

Cancer-induced bone pain is abundant among advanced stage cancer patients and arises from a primary tumor in the bone or skeletal metastasis of common cancer types such as breast, lung or prostate cancer. Recently, antibodies targeting nerve growth factor (NGF) have been shown to effectively relieve neuropathic and inflammatory pain states in mice and in humans. While efficacy has been shown in mice on a behavioral level, effectiveness in preventing pain-induced functional rearrangements in the central nervous system has not been shown. Therefore we assessed longitudinal whole-brain functional connectivity using resting-state fMRI in a mouse model of cancer-induced bone pain. We found functional connectivity between major hubs of ascending and descending pain pathways such as the periaqueductal gray, amygdala, thalamus as well as cortical somatosensory regions to be affected by a developing cancer pain state. These changes could be successfully prevented through prospective administration of a monoclonal anti-NGF antibody (mAb911). This indicates efficacy of anti-NGF treatment to prevent pain-induced adaptations in brain functional networks following persistent nociceptive input from cancer-induced bone pain. Additionally, it highlights the suitability of resting-state fMRI readouts as an indicator of treatment response on the basis of longitudinal functional network changes.