Chronic back pain is associated with decreased prefrontal and thalamic gray matter density

A. Vania Apkarian*, Yamaya Sosa, Sreepadma Sonty, Robert M. Levy, R. Norman Harden, Todd B. Parrish, Darren R. Gitelman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

910 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)10410-10415
Number of pages6
JournalJournal of Neuroscience
Volume24
Issue number46
DOIs
StatePublished - Nov 17 2004

Keywords

  • Aging
  • Chronic pain
  • Frontal cortex
  • Morphometry
  • Neuropathic back pain
  • Thalamus

ASJC Scopus subject areas

  • Neuroscience(all)

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