Cognitive Flexibility Training for Persistent Pain: Neuroimaging Pilot (COFLEX-i)

This project is a single-center prospective pilot study to assess whether cognitive
flexibility training through a Lumosity®-based training module over the course a five week
timeframe in patients with chronic hip, knee, and back pain results in detectable changes in
resting-state functional connectivity (rsFC). The investigators will explore changes in rsFC
particularly within the default mode (DMN), frontoparietal (FPN), and cingulo-opercular (CON)
brain networks.

Inclusion Criteria:

- Adults between 18 to 70 years old with chronic hip, knee or back pain for >3 months

- Documented moderate to severe chronic pain

- English fluency

- Access to a computer at home and an email account

Exclusion Criteria:

- Lack of email/lack of basic computer skills

- Diagnosed Alzheimer's or documented severe cognitive impairment

- Severely impaired vision or color blindness

- Unable to complete cognitive testing

- An interventional pain procedure within one week prior to enrollment testing

- Scheduled to undergo a pain procedure during the five weeks of cognitive training

- Self-reported claustrophobia

- Contraindication to an MRI scan (i.e. presence of metallic foreign body such as an
artificial joint or aneurism clip, implanted pacemaker or spinal cord stimulator)