Back Pain - Injury or Accident
February 26, 2008 12:57 PM11/04 Neuroscience article shows objectively that those in chronic pain have resultant cortical atrophy. i.e. the brain shrinks. Great article. It is not the only one, by the way. Here is abstract:
1: J Neurosci. 2004 Nov 17;24(46):10410-5.
Chronic back pain is associated with decreased prefrontal and thalamic gray
matter density.
Apkarian AV, Sosa Y, Sonty S, Levy RM, Harden RN, Parrish TB, Gitelman DR.
Department of Physiology and Institute of Neuroscience, Northwestern University
Feinberg School of Medicine, Chicago, Illinois 60611, USA.
a-apkarian@northwestern.edu
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.
