Paul Gallagher Liam Lindsay, Tom Barkhuizen and Brad Potts came into the side at the Riverside Stadium, replacing Daniel Johnson, Paul Huntington, Sean Maguire and Ben Whiteman who dropped to the bench.
It was Gallagher's first start since the 2-0 win over Coventry City on December 29, with him handed a deeper midfield role next to skipper Alan Browne.
Lindsay came into the centre of defence having returned to the bench at Wycombe having been sidelined by a hamstring injury.
Potts was given the attacking midfield role behind striker Ched Evans.
Middlesbrough: Bettinelli, Fisher, Fry, Hall, Bola, McNair, Howson, Morsy, Kebano, Bolaise, Akpom. Subs: Spence, Coulson, Saville, Johnson, Tavernier, Mendez-Laing, Watmore, Fletcher, Archer.
PNE: Iversen, van den Berg, Storey, Lindsay, Hughes, Browne, Gallagher, Barkhuizen, Potts, Sinclair, Evans. Subs: Rafferty, Huntington, Molumby, Johnson, Whiteman, Maguire, Gordon, Riis, Ripley.
Referee: Oliver Langford (West Midlands)
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