Poster No:
2527
Submission Type:
Abstract Submission
Authors:
Katerina Zorina-Lichtenwalter1, Marta Čeko1, Lydia Rader1, Martin Lindquist2, Naomi Friedman1, Tor Wager3
Institutions:
1University of Colorado, Boulder, CO, 2Johns Hopkins University, Baltimore, MD, 3Dartmouth College, Hanover, NH
Co-Author(s):
Introduction:
Chronic pain patients have alterations in brain gray and white matter, as identified in MRI-based studies (Kregel et al. 2015; Vachon-Presseau et al. 2016). However, small samples have yielded largely inconsistent findings, and only recently have large-scale studies assessed brain structure and pain in samples sufficient to test these relationships with high power. In addition, whether these anomalies result from, lead to, or are merely comorbid with prolonged pain remains unclear. We investigated the relationship between T1 MRI-based measures of brain structure and chronic pain in 40,000 U. K. Biobank (UKB) participants (Littlejohns et al. 2020).
Methods:
We analyzed longitudinal data on chronic pain (>3 months duration) in eight body sites (head, face, neck/shoulder, back, stomach, hip, knee, and all over) assessed at baseline (no MRI) and during an MRI visit four or more years later. We grouped participants into four categories: (1) pain-free controls (N = 14,150); (2) unresolved chronic pain at one or more body sites at both assessments (N = 10,532); (3) chronic pain at baseline that resolved by the MRI visit (N = 5,716); and (4) New-onset chronic pain at the MRI visit that was absent at the baseline visit (N = 4,656). We used multiple linear regression models to estimate associations between these categories and regional measures of gray matter volume, cortical thickness, and surface area, controlling for demographics (age, sex), intracranial volume, and scan site (four sites).
Results:
Unresolved pain is associated with widespread gray matter volume and surface area reduction compared with pain-free controls in both cortical and subcortical regions, including bilateral sensorimotor and medial prefrontal cortices; new chronic pain is associated with limited gray matter volume reduction focused in cortical regions most affected in the unresolved pain group, and no changes in subcortical regions; resolved pain is associated with surface area reduction exclusively in the somatosensory cortex.
Conclusions:
Collectively, these findings suggest a pervasive, partially reversible spreading of gray matter loss across the brain that correlates with chronic pain duration. We have thus identified brain markers of chronic pain progression and resolution, which may be targeted in novel treatment approaches, such as neuromodulation.
Modeling and Analysis Methods:
Task-Independent and Resting-State Analysis 2
Neuroanatomy, Physiology, Metabolism and Neurotransmission:
Cortical Anatomy and Brain Mapping
Subcortical Structures
Novel Imaging Acquisition Methods:
Anatomical MRI
Perception, Attention and Motor Behavior:
Perception: Pain and Visceral 1
Keywords:
Headache
MRI
Pain
Somatosensory
STRUCTURAL MRI
Sub-Cortical
Univariate
1|2Indicates the priority used for review
Provide references using author date format
Kregel, J. (2015). 'Structural and Functional Brain Abnormalities in Chronic Low Back Pain: A Systematic Review.' Seminars in Arthritis and Rheumatism 45 (2), pp. 229–37.
Littlejohns, T. J. (2020), 'The UK Biobank imaging enhancement of 100,000 participants: rationale, data collection, management and future directions,' Nature communications, 11(1), pp. 2624.
Vachon-Presseau, E. (2016), 'Corticolimbic Anatomical Characteristics Predetermine Risk for Chronic Pain.' Brain: A Journal of Neurology 139 (Pt 7), pp. 1958–70.