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Behavioral/Systems/Cognitive Chronic Back Pain Is Associated with Decreased Prefrontal
 

Summary: 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.
PatientswithCBPshowed511%lessneocorticalgraymattervolumethancontrolsubjects.Themagnitudeofthisdecreaseisequivalent
to the gray matter volume lost in 1020 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
cortexandrightthalamusandwasstronglyrelatedtopaincharacteristicsinapatterndistinctforneuropathicandnon-neuropathicCBP.
Our results imply that CBP is accompanied by brain atrophy and suggest that the pathophysiology of chronic pain includes thalamocor-
tical processes.
Key words: chronic pain; morphometry; frontal cortex; thalamus; neuropathic back pain; aging
Introduction

  

Source: Apkarian, A. Vania - Department of Physiology, Northwestern University

 

Collections: Biology and Medicine