Article Figures & Data
Figures
- Figure 1.
Statistical parametric maps demonstrating the structural difference in gray matter in patients with chronic pain due to primary hip OA (not flipped). Significant gray matter changes are shown superimposed in color (decrease of gray matter) on a normalized image of a healthy control subject. The left side of the picture is the left side of the brain. A , Significant decrease of gray matter between patients with chronic pain due to primary hip OA and unaffected control subjects. B , Gray matter increase in 10 pain-free patients at the third scanning period 16–18 weeks after total hip replacement surgery, compared with the first (preoperative) and second (6 weeks postsurgery) scans.
- Figure 2.
Gray matter changes in the longitudinal group (n = 10) between the first two scans (before the operation and 6–8 weeks after the operation) with the third scan (pain free 16–18 weeks after the operation). Each box plot represents relative gray matter percentage signal change over time and 90% confidence interval (gray line) averaged over the cluster of the dorsolateral prefrontal cortex ( A ), amygdala ( B ), S2 cortex ( C ), insular cortex ( D ), brainstem ( E ), and anterior cingulate cortex ( F ). C.I., Confidence interval.
Tables
- Table 1.
Demographic details of 10 patients with primary hip osteoarthritis undergoing total hip replacement surgery
V Sex Age(years) Pain scorebefore surgery Pain duration(years) Side ofpain Pain medicationbefore surgery Type ofmedication Pain scoreafter surgery Pain medicationafter surgery 1 M 66 80 4 R Yes Diclofenac 0 No 2 F 74 90 1 R No n.a. 0 No 3 F 66 80 4 R Yes Diclofenac 0 No 4 F 60 70 18 R Yes Ibuprofen 0 No 5 M 66 60 1 L Yes Diclofenac 0 No 6 M 49 90 8 L Yes Acemetacin, Sulfasalacin 0 No 7 M 80 50 3 L No n.a 0 No 8 F 72 75 1 L Yes Ibuprofen, Verapamil 0 No 9 F 44 60 3 L No n.a 0 No 10 F 69 40 5 R Yes Diclofenac 0 No -
Pain score is given as values of a numerical rating scale anchored at 0 = no pain and 100 = worst pain ever. M, Male; F, female; R, right; L, left; n.a., not applicable.
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- Table 2.
Significant changes in gray matter density in patients with chronic pain due to primary hip osteoarthritis
Anatomical location Patients < controls MNI coordinates p Peak t score Number of voxels Testing periods 1, 2 <3 MNI coordinates p Peak t score Number of voxels x y z x y z L anterior cingulate cortex −4 39 3 0.000 4.48 3401 −2 34 0 0.007 2.75 813 R amygdala 28 1 −15 0.001 3.31 4 28 0 −13 0.001 3.83 11,161 R DLPFC 23 49 38 0.000 3.79 226 23 31 40 0.008 2.64 877 L midcingulate cortex −11 −14 35 0.000 4.02 75 −17 −18 50 0.007 2.75 219 R insular cortex 51 17 1 0.000 5.38 4468 36 9 1 0.004 2.99 11,161 L insular cortex −41 26 4 0.000 4.02 287 −44 27 −13 0.010 2.53 712 Brainstem 2 −30 −48 0.000 3.72 20 0 −28 −42 0.008 2.68 1063 L medial temporal gyrus/S2 −62 −17 0 0.000 4.07 1201 −58 −5 −10 0.012 2.47 493 R anterior cingulate cortex 12 23 24 0.000 4.19 326 2 33 1 0.009 2.39 813 L midorbital gyrus −9 24 −22 0.000 4.65 1248 R midorbital gyrus 6 62 −12 0.000 5.10 776 R superior frontal gyrus/area 6 21 −6 59 0.000 4.13 166 R medial temporal pole 27 9 −42 0.000 3.69 49 R cerebellum 18 −43 −33 0.000 4.64 1544 R superior medial gyrus 9 66 13 0.000 4.17 244 R area 2/S1 54 −32 53 0.000 3.92 161 -
The changes are tabulated in terms of the brain region and the corresponding Brodmann's area. The x, y, z coordinates are according to the Montreal Neurological Institute (MNI) atlas. Each location is the peak within a cluster (defined as the voxel with the highest z score). The left side of the table (“patients < controls”) lists significant decreases of gray matter between patients and controls with a statistical threshold set at p < 0.001 uncorrected. The right side of the table (“testing periods 1, 2 <3”) lists corresponding areas showing a gray matter increase in 10 pain-free patients at the third scanning period 12–18 weeks after total hip replacement surgery, as compared to the first (preoperative) and second (6 weeks post surgery) scans (p < 0.05 uncorrected). R, Right side; L, left side.
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