Corticolimbic anatomical characteristics predetermine risk for chronic pain

Etienne Vachon-Presseau, Pascal Tétreault, Bogdan Petre, Lejian Huang, Sara E. Berger, Souraya Torbey, Alexis T. Baria, Ali R. Mansour, Javeria A. Hashmi, James W. Griffith, Erika Comasco, Thomas J. Schnitzer, Marwan N. Baliki, A. Vania Apkarian*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

113 Scopus citations

Abstract

See Tracey (doi:10.1093/brain/aww147) for a scientific commentary on this article. Mechanisms of chronic pain remain poorly understood. We tracked brain properties in subacute back pain patients longitudinally for 3 years as they either recovered from or transitioned to chronic pain. Whole-brain comparisons indicated corticolimbic, but not pain-related circuitry, white matter connections predisposed patients to chronic pain. Intra-corticolimbic white matter connectivity analysis identified three segregated communities: dorsal medial prefrontal cortex-amygdala-accumbens, ventral medial prefrontal cortex-amygdala, and orbitofrontal cortex-amygdala-hippocampus. Higher incidence of white matter and functional connections within the dorsal medial prefrontal cortex-amygdala-accumbens circuit, as well as smaller amygdala volume, represented independent risk factors, together accounting for 60% of the variance for pain persistence. Opioid gene polymorphisms and negative mood contributed indirectly through corticolimbic anatomical factors, to risk for chronic pain. Our results imply that persistence of chronic pain is predetermined by corticolimbic neuroanatomical factors.

Original languageEnglish (US)
Pages (from-to)1958-1970
Number of pages13
JournalBrain
Volume139
Issue number7
DOIs
StatePublished - Jul 1 2016

Keywords

  • brain network
  • chronic pain
  • diffusion tensor imaging (DTI)
  • limbic system
  • magnetic resonance imaging (MRI)

ASJC Scopus subject areas

  • Clinical Neurology

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