RT Journal Article
SR Electronic
T1 Chronic Back Pain Is Associated with Decreased Prefrontal and Thalamic Gray Matter Density
JF The Journal of Neuroscience
JO J. Neurosci.
FD Society for Neuroscience
SP 10410
OP 10415
DO 10.1523/JNEUROSCI.2541-04.2004
VO 24
IS 46
A1 Apkarian, A. Vania
A1 Sosa, Yamaya
A1 Sonty, Sreepadma
A1 Levy, Robert M.
A1 Harden, R. Norman
A1 Parrish, Todd B.
A1 Gitelman, Darren R.
YR 2004
UL http://www.jneurosci.org/content/24/46/10410.abstract
AB 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.