M de Kruijf1, D Bos2, F J P M Huygen3, W J Niessen4, H Tiemeier5, A Hofman5, A G Uitterlinden6, M W Vernooij2, M A Ikram7, J B J van Meurs8. 1. From the Departments of Internal Medicine (M.d.K., A.G.U., J.B.J.v.M.) Anaesthesiology (M.d.K., F.J.P.M.H.). 2. Radiology (D.B., W.J.N., M.W.V., M.A.I.) Epidemiology (D.B., H.T., A.H., A.G.U., M.W.V., M.A.I.). 3. Anaesthesiology (M.d.K., F.J.P.M.H.). 4. Radiology (D.B., W.J.N., M.W.V., M.A.I.) Medical Informatics (W.J.N.) Faculty of Applied Sciences (W.J.N.), Delft University of Technology, Delft, the Netherlands. 5. Epidemiology (D.B., H.T., A.H., A.G.U., M.W.V., M.A.I.). 6. From the Departments of Internal Medicine (M.d.K., A.G.U., J.B.J.v.M.) Epidemiology (D.B., H.T., A.H., A.G.U., M.W.V., M.A.I.). 7. Radiology (D.B., W.J.N., M.W.V., M.A.I.) Epidemiology (D.B., H.T., A.H., A.G.U., M.W.V., M.A.I.) Neurology (M.A.I.), Erasmus MC, University Medical Center, Rotterdam, the Netherlands. 8. From the Departments of Internal Medicine (M.d.K., A.G.U., J.B.J.v.M.) j.vanmeurs@erasmusmc.nl.
Abstract
BACKGROUND AND PURPOSE: Central sensitization in chronic pain involves structural brain changes that influence vulnerability to pain. Identifying brain regions involved in pain processing and sensitization can provide more insight into chronic pain. This study examines structural brain changes in chronic pain and experimental pain in a large population-based study. MATERIALS AND METHODS: For 3892 participants in the Rotterdam study, global and regional MR imaging brain volumes were automatically segmented and quantified. Chronic joint pain was defined as pain for more than half of all days during the past 6 weeks. Heat pain thresholds were measured in a subset of 1538 individuals. The association between the presence of chronic joint pain and global and lobar brain volumes was studied. Subsequently, literature was reviewed and the association of chronic pain and heat pain thresholds with 11 brain regions associated with musculoskeletal pain in previous publications was studied. RESULTS: Total gray matter volume was smaller in women with chronic pain (β = -0.066, P = .016). This effect was primarily driven by lower gray matter volume in the temporal lobe (β = 0.086, P = .005), the frontal lobe (β = -0.060, P = .039), and the hippocampus (β = -0.099, P = .002). In addition, we observed that a lower heat pain threshold was associated with smaller volumes of the hippocampus (β = 0.017, P = .048), the thalamus (β = 0.018, P = .009), and the anterior cingulate cortex (β = -0.016, P = .037). In men, no significant associations were observed. CONCLUSIONS: The primary identified brain areas, the temporal and frontal lobes and the hippocampus, indicated involvement of emotional processing. The volumetric differences found indicated a sex-specific neuroplasticity in chronic pain. These results emphasized sex-specific and multidisciplinary pain treatment.
BACKGROUND AND PURPOSE: Central sensitization in chronic pain involves structural brain changes that influence vulnerability to pain. Identifying brain regions involved in pain processing and sensitization can provide more insight into chronic pain. This study examines structural brain changes in chronic pain and experimental pain in a large population-based study. MATERIALS AND METHODS: For 3892 participants in the Rotterdam study, global and regional MR imaging brain volumes were automatically segmented and quantified. Chronic joint pain was defined as pain for more than half of all days during the past 6 weeks. Heat pain thresholds were measured in a subset of 1538 individuals. The association between the presence of chronic joint pain and global and lobar brain volumes was studied. Subsequently, literature was reviewed and the association of chronic pain and heat pain thresholds with 11 brain regions associated with musculoskeletal pain in previous publications was studied. RESULTS: Total gray matter volume was smaller in women with chronic pain (β = -0.066, P = .016). This effect was primarily driven by lower gray matter volume in the temporal lobe (β = 0.086, P = .005), the frontal lobe (β = -0.060, P = .039), and the hippocampus (β = -0.099, P = .002). In addition, we observed that a lower heat pain threshold was associated with smaller volumes of the hippocampus (β = 0.017, P = .048), the thalamus (β = 0.018, P = .009), and the anterior cingulate cortex (β = -0.016, P = .037). In men, no significant associations were observed. CONCLUSIONS: The primary identified brain areas, the temporal and frontal lobes and the hippocampus, indicated involvement of emotional processing. The volumetric differences found indicated a sex-specific neuroplasticity in chronic pain. These results emphasized sex-specific and multidisciplinary pain treatment.
Authors: David A Seminowicz; Timothy H Wideman; Lina Naso; Zeinab Hatami-Khoroushahi; Summaya Fallatah; Mark A Ware; Peter Jarzem; M Catherine Bushnell; Yoram Shir; Jean A Ouellet; Laura S Stone Journal: J Neurosci Date: 2011-05-18 Impact factor: 6.167
Authors: Margaret M McCarthy; Anthony P Auger; Tracy L Bale; Geert J De Vries; Gregory A Dunn; Nancy G Forger; Elaine K Murray; Bridget M Nugent; Jaclyn M Schwarz; Melinda E Wilson Journal: J Neurosci Date: 2009-10-14 Impact factor: 6.167
Authors: Markus Burgmer; Markus Gaubitz; Carsten Konrad; Marco Wrenger; Sebastian Hilgart; Gereon Heuft; Bettina Pfleiderer Journal: Psychosom Med Date: 2009-05-04 Impact factor: 4.312
Authors: Michael V Lombardo; Emma Ashwin; Bonnie Auyeung; Bhismadev Chakrabarti; Kevin Taylor; Gerald Hackett; Edward T Bullmore; Simon Baron-Cohen Journal: J Neurosci Date: 2012-01-11 Impact factor: 6.167
Authors: M Arfan Ikram; Guy G O Brusselle; Sarwa Darwish Murad; Cornelia M van Duijn; Oscar H Franco; André Goedegebure; Caroline C W Klaver; Tamar E C Nijsten; Robin P Peeters; Bruno H Stricker; Henning Tiemeier; André G Uitterlinden; Meike W Vernooij; Albert Hofman Journal: Eur J Epidemiol Date: 2017-10-24 Impact factor: 8.082