 |
The Journal of Neuroscience, November 17, 2004, 24(46):10410-10415; doi:10.1523/JNEUROSCI.2541-04.2004
 Previous Article | Next Article 
Behavioral/Systems/Cognitive
Chronic Back Pain Is Associated with Decreased Prefrontal and Thalamic Gray Matter Density
A. Vania Apkarian,1
Yamaya Sosa,1
Sreepadma Sonty,2
Robert M. Levy,3
R. Norman Harden,5
Todd B. Parrish,4 and
Darren R. Gitelman2,4
1Department of Physiology and Institute of Neuroscience, and Departments of 2Neurology, 3Neurosurgery, and 4Radiology, and 5Rehabilitation Institute of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611
The role of the brain in chronic pain conditions remains speculative. We compared brain morphology of 26 chronic back pain (CBP) patients to matched control subjects, using magnetic resonance imaging brain scan data and automated analysis techniques. CBP patients were divided into neuropathic, exhibiting pain because of sciatic nerve damage, and non-neuropathic groups. Pain-related characteristics were correlated to morphometric measures. Neocortical gray matter volume was compared after skull normalization. Patients with CBP showed 5-11% less neocortical gray matter volume than control subjects. The magnitude of this decrease is equivalent to the gray matter volume lost in 10-20 years of normal aging. The decreased volume was related to pain duration, indicating a 1.3 cm3 loss of gray matter for every year of chronic pain. Regional gray matter density in 17 CBP patients was compared with matched controls using voxel-based morphometry and nonparametric statistics. Gray matter density was reduced in bilateral dorsolateral prefrontal cortex and right thalamus and was strongly related to pain characteristics in a pattern distinct for neuropathic and non-neuropathic CBP. Our results imply that CBP is accompanied by brain atrophy and suggest that the pathophysiology of chronic pain includes thalamocortical processes.
Key words: chronic pain; morphometry; frontal cortex; thalamus; neuropathic back pain; aging
Received June 25, 2004;
revised October 11, 2004;
accepted October 12, 2004.
This article has been cited by other articles:
|
|
|
|
 
R. Luerding, T. Weigand, U. Bogdahn, and T. Schmidt-Wilcke
Working memory performance is correlated with local brain morphology in the medial frontal and anterior cingulate cortex in fibromyalgia patients: structural correlates of pain-cognition interaction
Brain,
September 26, 2008;
(2008)
awn229v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Buchgreitz, L.L. Egsgaard, R. Jensen, L. Arendt-Nielsen, and L. Bendtsen
Abnormal pain processing in chronic tension-type headache: a high-density EEG brain mapping study
Brain,
August 30, 2008;
(2008)
awn199v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Tsao, M. P. Galea, and P. W. Hodges
Reorganization of the motor cortex is associated with postural control deficits in recurrent low back pain
Brain,
August 1, 2008;
131(8):
2161 - 2171.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. F. Karp, J. W. Shega, N. E. Morone, and D. K. Weiner
Advances in understanding the mechanisms and management of persistent pain in older adults
Br. J. Anaesth.,
July 1, 2008;
101(1):
111 - 120.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. N. Baliki, P. Y. Geha, A. V. Apkarian, and D. R. Chialvo
Beyond Feeling: Chronic Pain Hurts the Brain, Disrupting the Default-Mode Network Dynamics
J. Neurosci.,
February 6, 2008;
28(6):
1398 - 1403.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. D. Davis, G. Pope, J. Chen, C. L. Kwan, A. P. Crawley, and N. E. Diamant
CORTICAL THINNING IN IBS: IMPLICATIONS FOR HOMEOSTATIC, ATTENTION, AND PAIN PROCESSING
Neurology,
January 8, 2008;
70(2):
153 - 154.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. F.M. DaSilva, C. Granziera, J. Snyder, and N. Hadjikhani
Thickening in the somatosensory cortex of patients with migraine
Neurology,
November 20, 2007;
69(21):
1990 - 1995.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Seminowicz and K. D. Davis
Interactions of Pain Intensity and Cognitive Load: The Brain Stays on Task
Cereb Cortex,
June 1, 2007;
17(6):
1412 - 1422.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Kuchinad, P. Schweinhardt, D. A. Seminowicz, P. B. Wood, B. A. Chizh, and M. C. Bushnell
Accelerated Brain Gray Matter Loss in Fibromyalgia Patients: Premature Aging of the Brain?
J. Neurosci.,
April 11, 2007;
27(15):
4004 - 4007.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Rocca, A. Ceccarelli, A. Falini, B. Colombo, P. Tortorella, L. Bernasconi, G. Comi, G. Scotti, and M. Filippi
Brain Gray Matter Changes in Migraine Patients With T2-Visible Lesions: A 3-T MRI Study
Stroke,
July 1, 2006;
37(7):
1765 - 1770.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M A Rocca, A Ceccarelli, A Falini, P Tortorella, B Colombo, E Pagani, G Comi, G Scotti, and M Filippi
Diffusion tensor magnetic resonance imaging at 3.0 tesla shows subtle cerebral grey matter abnormalities in patients with migraine
J. Neurol. Neurosurg. Psychiatry,
May 1, 2006;
77(5):
686 - 689.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Benedetti, H. S. Mayberg, T. D. Wager, C. S. Stohler, and J.-K. Zubieta
Neurobiological Mechanisms of the Placebo Effect
J. Neurosci.,
November 9, 2005;
25(45):
10390 - 10402.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-K. Zubieta, J. A. Bueller, L. R. Jackson, D. J. Scott, Y. Xu, R. A. Koeppe, T. E. Nichols, and C. S. Stohler
Placebo Effects Mediated by Endogenous Opioid Activity on {micro}-Opioid Receptors
J. Neurosci.,
August 24, 2005;
25(34):
7754 - 7762.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
