Structural and functional brain abnormalities in chronic low back pain: A systematic review☆

Kregel, Jeroen; Meeus, Mira; Malfliet, Anneleen; Dolphens, Mieke; Danneels, Lieven; Nijs, Jo; Cagnie, Barbara

doi:10.1016/j.semarthrit.2015.05.002

Cited by 226 publications

(166 citation statements)

References 56 publications

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“…Furthermore, no cortical thickness differences were detected in all investigated brain regions between women with CINP and healthy women. Also, in contrast to our hypothesis and to the results of previous studies in patients with chronic musculoskeletal pain (Jensen et al, ; Kregel et al, ) and mild TBI (Govindarajan et al, ), differences in regional cortical thickness between CWAD patients and healthy controls could not be demonstrated. Yet, the cortical thickness MANCOVA model comprising all ROIs showed a partial eta squared of 0.31, which means that 31% of the variance in cortical thickness in the 9 ROIs can be explained by study group, which corresponds with a large effect size.…”

Section: Discussioncontrasting

confidence: 99%

Differences in white matter structure and cortical thickness between patients with traumatic and idiopathic chronic neck pain: Associations with cognition and pain modulation?

Coppieters

Pauw

Caeyenberghs

et al. 2018

Human Brain Mapping

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Brain alterations are hypothesized to be present in patients with chronic whiplash-associated disorders (CWAD). The aim of this case-control study was to examine alterations in cortical thickness and white matter (WM) structure, and the presence of brain microhemorrhages in a patient group encountering chronic neck pain of traumatic origin (i.e., CWAD) when compared with a patient group characterized by nontraumatic chronic neck pain [i.e., chronic idiopathic neck pain (CINP)], and healthy controls. Furthermore, we aimed to investigate associations between brain structure on one hand and cognitive performance and central sensitization (CS) on the other hand. T1-weighted, diffusion-weighted and T2*-weighted magnetic resonance images of the brain were acquired in 105 women (31 controls, 37 CINP, 37 CWAD) to investigate regional cortical thickness, WM structure, and microhemorrhages, respectively. Next, cognitive performance, and CS encompassing distant hyperalgesia and conditioned pain modulation (CPM) efficacy were examined. Cortical thinning in the left precuneus was revealed in CWAD compared with CINP patients. Also, decreased fractional anisotropy, together with increased values of mean diffusivity and radial diffusivity could be observed in the left cingulum hippocampus and tapetum in CWAD compared with CINP, and in the left tapetum in CWAD patients compared with controls. Moreover, the extent of WM structural deficits in the left tapetum coincided with decreased CPM efficacy in the CWAD group. This yields evidence for associations between decreased endogenous pain inhibition, and the degree of regional WM deficits in CWAD. Our results emphasize the role of structural brain alterations in women with CWAD compared with CINP.

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Section: Discussioncontrasting

confidence: 99%

Differences in white matter structure and cortical thickness between patients with traumatic and idiopathic chronic neck pain: Associations with cognition and pain modulation?

Coppieters

Pauw

Caeyenberghs

et al. 2018

Human Brain Mapping

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show abstract

“…Previous studies have indicated that chronic pain can induce volume changes in the brain (May, 2008; Kregel et al, 2015; de Kruijf et al, 2016). The brain gray matter is closely associated with the body’s pain perception (Cauda et al, 2014; Emerson et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Microstructural Abnormalities Were Found in Brain Gray Matter from Patients with Chronic Myofascial Pain

et al. 2016

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Myofascial pain, presented as myofascial trigger points (MTrPs)-related pain, is a common, chronic disease involving skeletal muscle, but its underlying mechanisms have been poorly understood. Previous studies have revealed that chronic pain can induce microstructural abnormalities in the cerebral gray matter. However, it remains unclear whether the brain gray matters of patients with chronic MTrPs-related pain undergo alteration. In this study, we employed the Diffusion Kurtosis Imaging (DKI) technique, which is particularly sensitive to brain microstructural perturbation, to monitor the MTrPs-related microstructural alterations in brain gray matter of patients with chronic pain. Our results revealed that, in comparison with the healthy controls, patients with chronic myofascial pain exhibited microstructural abnormalities in the cerebral gray matter and these lesions were mainly distributed in the limbic system and the brain areas involved in the pain matrix. In addition, we showed that microstructural abnormalities in the right anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC) had a significant negative correlation with the course of disease and pain intensity. The results of this study demonstrated for the first time that there are microstructural abnormalities in the brain gray matter of patients with MTrPs-related chronic pain. Our findings may provide new insights into the future development of appropriate therapeutic strategies to this disease.

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“…It is possible that the long-lasting TN pain created more demands for pain modulation, expressed as relatively increased FCDs in these affective-cognitive and sensory modulation pathways. The DMN has been known to be altered in pain diseases and to be involved in cognitive and memory-related aspects of pain modulation414243. It was reported that the neuropathic pain engaged brain regions critical for cognitive assessment, emphasizing the unique role of the PFC in pain states44.…”

Section: Discussionmentioning

confidence: 99%

Brain white matter plasticity and functional reorganization underlying the central pathogenesis of trigeminal neuralgia

Tian

Guo

et al. 2016

Sci Rep

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Peripheral nerve damage does not fully explain the pathogenesis of trigeminal neuralgia (TN). Central nervous system changes can follow trigeminal nerve dysfunction. We hypothesized that brain white matter and functional connectivity changes in TN patients were involved in pain perception, modulation, the cognitive-affective system, and motor function; moreover, changes in functional reorganization were correlated with white matter alterations. Twenty left TN patients and twenty-two healthy controls were studied. Diffusion kurtosis imaging was analyzed to extract diffusion and kurtosis parameters, and functional connectivity density (FCD) mapping was used to explore the functional reorganization in the brain. In the patient group, we found lower axial kurtosis and higher axial diffusivity in tracts participated in sensory, cognitive-affective, and modulatory aspects of pain, such as the corticospinal tract, superior longitudinal fasciculus, anterior thalamic radiation, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, cingulated gyrus, forceps major and uncinate fasciculus. Patients exhibited complex FCD reorganization of hippocampus, striatum, thalamus, precentral gyrus, precuneus, prefrontal cortex and inferior parietal lobule in multiple modulatory networks that played crucial roles in pain perception, modulation, cognitive-affective system, and motor function. Further, the correlated structural-functional changes may be responsible for the persistence of long-term recurrent pain and sensory-related dysfunction in TN.

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Structural and functional brain abnormalities in chronic low back pain: A systematic review☆

Cited by 226 publications

References 56 publications

Differences in white matter structure and cortical thickness between patients with traumatic and idiopathic chronic neck pain: Associations with cognition and pain modulation?

Differences in white matter structure and cortical thickness between patients with traumatic and idiopathic chronic neck pain: Associations with cognition and pain modulation?

Microstructural Abnormalities Were Found in Brain Gray Matter from Patients with Chronic Myofascial Pain

Brain white matter plasticity and functional reorganization underlying the central pathogenesis of trigeminal neuralgia

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