Influencing factors of brain alterations in chronic pain
Human Cognitive and Systems Neuroscience
Final Report Abstract
Chronic pain is one of the most prevalent health problems worldwide, placing an extreme burden on both patients and healthcare systems, and is associated with a high number of years with disability. As chronic pain can only be perceived subjectively, the search for objectively measurable parameters ("biomarkers") that can provide information about the underlying mechanisms and possible therapeutic approaches has been ongoing for some time. One possible biomarker are characteristic changes in grey matter volume associated with chronic pain disorders. In a cohort study of several thousand people from the general population, we compared the grey matter volume of people with chronic back pain, migraine and craniomandibular dysfunction to people without pain. Reductions in grey matter volume were found in regions of the brain that process pain (insula, anterior cingulate cortex) and in the hippocampus, which was related to stressful life events in the previous 12 months. Another study, which examined people with chronic back pain twice over an average of seven years, showed that chronic back pain not only reduced grey matter volume in the parahippocampal gyrus, but also increased grey matter volume in the ventral striatum, which tends to be associated with emotional networks. This suggests that the processing of painful stimuli shifts to emotional networks during the course of the disease, as previously postulated. In addition, people who went on to develop chronic back pain already had less grey matter in the right entorhinal cortex, right amygdala and left medial frontal cortex at the first time point, which may represent predisposing risk factors for the development of chronic pain. Overall, it was shown that grey matter volume was reduced in chronic pain at sites characteristic of pain processing and that the brain undergoes plastic changes during the course of a pain disorder.
Publications
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Chronic pain is associated with less grey matter volume in the anterior cingulum, anterior and posterior insula and hippocampus across three different chronic pain conditions. European Journal of Pain, 27(10), 1239-1248.
Neumann, Nicola; Domin, Martin; Schmidt, Carsten‐Oliver & Lotze, Martin
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Gray matter volume of limbic brain structures during the development of chronic back pain: a longitudinal cohort study. Pain, 166(2), 438-447.
Neumann, Nicola; Domin, Martin & Lotze, Martin
