期刊
JOURNAL OF NEUROSCIENCE
卷 24, 期 46, 页码 10410-10415出版社
SOC NEUROSCIENCE
DOI: 10.1523/JNEUROSCI.2541-04.2004
关键词
chronic pain; morphometry; frontal cortex; thalamus; neuropathic back pain; aging
资金
- Intramural NIH HHS [Z01 AG000940] Funding Source: Medline
- NIA NIH HHS [K23 AG-00940, K23 AG000940-05] Funding Source: Medline
- NINDS NIH HHS [R01 NS035115, NS-35115] Funding Source: Medline
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 cm(3) 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.
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