OBJECTIVE: To investigate whether the functional changes in pain disorder might be reflected by structural brain changes. Pain disorder assessed with the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria is characterized by persistent and distressing chronic pain at one or more body sites which cannot be fully explained by a physiological process or somatic disorder. Psychological factors are thought to play a major role. Recent neuroimaging studies evidenced altered pain processing in patients suffering from this disorder. METHODS: Fourteen right-handed women fulfilling the DSM-IV criteria for pain disorder and 25 healthy age-matched women were investigated with magnetic resonance imaging. In the voxel-based morphometry analysis, we compared both groups for changes of gray-matter density. We included age and Beck Depression Inventory scores as nuisance variables to minimize possible confounding effects of age or depressive comorbidity. RESULTS: In the patient group, we found significant gray-matter decreases in the prefrontal, cingulate, and insular cortex. These regions are known to be critically involved in the modulation of subjective pain experiences. CONCLUSIONS: In the context of similar results in patients with other functional pain syndromes, such as fibromyalgia and chronic back pain, we suggest that structural changes in fronto-limbic brain circuits represent not only an objective marker of these pain syndromes but also constitute a critical pathophysiological element. These findings represent a further proof of the important role of central changes in pain disorder.
OBJECTIVE: To investigate whether the functional changes in pain disorder might be reflected by structural brain changes. Pain disorder assessed with the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria is characterized by persistent and distressing chronic pain at one or more body sites which cannot be fully explained by a physiological process or somatic disorder. Psychological factors are thought to play a major role. Recent neuroimaging studies evidenced altered pain processing in patients suffering from this disorder. METHODS: Fourteen right-handed women fulfilling the DSM-IV criteria for pain disorder and 25 healthy age-matched women were investigated with magnetic resonance imaging. In the voxel-based morphometry analysis, we compared both groups for changes of gray-matter density. We included age and Beck Depression Inventory scores as nuisance variables to minimize possible confounding effects of age or depressive comorbidity. RESULTS: In the patient group, we found significant gray-matter decreases in the prefrontal, cingulate, and insular cortex. These regions are known to be critically involved in the modulation of subjective pain experiences. CONCLUSIONS: In the context of similar results in patients with other functional pain syndromes, such as fibromyalgia and chronic back pain, we suggest that structural changes in fronto-limbic brain circuits represent not only an objective marker of these pain syndromes but also constitute a critical pathophysiological element. These findings represent a further proof of the important role of central changes in pain disorder.
Authors: A Gutzeit; D Meier; M L Meier; C von Weymarn; D A Ettlin; N Graf; J M Froehlich; C A Binkert; M Brügger Journal: Eur Radiol Date: 2010-10-02 Impact factor: 5.315
Authors: John R Keltner; Colm G Connolly; Florin Vaida; Mark Jenkinson; Christine Fennema-Notestine; Sarah Archibald; Cherine Akkari; Alexandra Schlein; Jisu Lee; Dongzhe Wang; Sung Kim; Han Li; Austin Rennels; David J Miller; George Kesidis; Donald R Franklin; Chelsea Sanders; Stephanie Corkran; Igor Grant; Gregory G Brown; J Hampton Atkinson; Ronald J Ellis Journal: Pain Med Date: 2017-03-01 Impact factor: 3.750
Authors: Rachel F Smallwood; Angela R Laird; Amy E Ramage; Amy L Parkinson; Jeffrey Lewis; Daniel J Clauw; David A Williams; Tobias Schmidt-Wilcke; Michael J Farrell; Simon B Eickhoff; Donald A Robin Journal: J Pain Date: 2013-05-17 Impact factor: 5.820