Chronic back pain is associated with decreased prefrontal and thalamic gray matter density
Chronic back pain is associated with decreased prefrontal and thalamic gray matter density
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DOI：
10.1523/jneurosci.2541-04.2004
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发表时间：
2004-11-17
影响因子：
5.3
通讯作者：
Gitelman, DR
中科院分区：
文献类型：
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作者：
Apkarian, AV;Sosa, Y;Gitelman, DR
大脑在慢性疼痛状况中的作用仍然是推测性的。我们利用磁共振成像脑部扫描数据和自动分析技术，将26名慢性背痛（CBP）患者的大脑形态与匹配的对照组进行了比较。慢性背痛患者被分为神经性（因坐骨神经损伤而疼痛）和非神经性两组。疼痛相关特征与形态测量指标相关。在颅骨标准化后比较了新皮质灰质体积。慢性背痛患者的新皮质灰质体积比对照组少5 - 11%。这种减少的程度相当于正常衰老10 - 20年所损失的灰质体积。体积的减少与疼痛持续时间有关，表明慢性疼痛每持续一年，灰质就会减少1.3立方厘米。利用基于体素的形态测量法和非参数统计方法，将17名慢性背痛患者的局部灰质密度与匹配的对照组进行了比较。双侧背外侧前额叶皮质和右侧丘脑的灰质密度降低，并且与神经性和非神经性慢性背痛不同模式的疼痛特征密切相关。我们的研究结果表明慢性背痛伴有脑萎缩，并提示慢性疼痛的病理生理学包括丘脑皮质过程。
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.