Can Brain Structure Predict Chronic Pain?

Anticonvulsants
Anticonvulsants

Recent research supported by the National Institute of Neurological Disorders and Stroke (NINDS) suggests that brain structure may predict whether a person will suffer chronic low back pain.

Low back pain represents about 28% of all causes of pain in the United States; about 23% of these patients suffer chronic low back pain. The cause of low back pain was thought to be found at the site of injury but recent studies suggest that the brain may play a bigger role regarding chronic pain.

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Vania Apkarian, PhD, a senior author of the study, and colleagues conducted brain scans of people (n=46) who had low back pain for about three months before coming to the hospital but who had not any pain for at least a year before.  

In addition to the brain scans, pain evaluations with doctor's examinations and questionnaires were conducted four times over a year. About half of the subjects recovered at some point during the year while the other half had pain throughout (“persistent”).

The researchers used a diffusion tensor imaging (DTI) technique, which measures white matter structure, the axons, which connect brain cells throughout the brain. There was a consistent difference in white matter between the subjects who recovered and those who experienced pain throughout the year. 

Researchers found that the white matter in patients with persistent pain was similar to a third group of subjects known to suffer from chronic pain. Further, the white matter in patients who recovered was similar to that of healthy control subjects.

In previous research, the laboratory showed that the volume of grey matter in the brains of the same subjects who had persistent pain decreased over the same year. Also, it was shown that brain activity could be used to predict whether a subject recovered or experienced persistent pain.

Researchers found that the initial white matter brain scans predicted at least 80% of the outcomes.  The findings support that certain brain networks are linked to chronic pain, and further research will help improve diagnoses and treatment for chronic pain.

The results of this research are published in the journal Pain.

For more information call (800) 352-9424 or visit the NINDS website.

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