Neumann Nicola, Domin Martin, Lotze Martin
Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany.
Pain. 2025 Feb 1;166(2):438-447. doi: 10.1097/j.pain.0000000000003351. Epub 2024 Aug 20.
This study set out to investigate in a population-based longitudinal cohort, whether chronification of back pain (BP) is related to structural gray matter changes in corticolimbic brain structures. Gray matter volume (GMV) was measured in participants with chronic BP (CBP, n = 168) and controls without chronic pain (n = 323) at 2 time points with an interval of 7 years (baseline t1, follow-up t2). Over this time period, participants with CBP showed an increase of GMV in the left ventral striatum, whereas controls showed a decrease. By contrast, participants with CBP had a GMV decrease in the left parahippocampal gyrus. Within the CBP group, pain duration was negatively associated with GMV in the left caudate. Those with emerging CBP had less GMV in the right entorhinal area, right amygdala, and left medial frontal cortex. Additional variables differing between those who had BP at t1 and later developed CBP or not were pain intensity, body mass index, and depression score. In sum, these findings are in accordance with the notion that limbic brain properties are both predisposing risk factors and drivers of brain reorganization during the development of CBP.
本研究旨在基于人群的纵向队列中调查背痛（BP）的慢性化是否与皮质边缘脑结构中的灰质结构变化相关。在两个时间点（间隔7年，基线t1和随访t2）对慢性背痛患者（CBP，n = 168）和无慢性疼痛的对照组（n = 323）测量灰质体积（GMV）。在此期间，CBP患者左侧腹侧纹状体的GMV增加，而对照组则减少。相比之下，CBP患者左侧海马旁回的GMV减少。在CBP组中，疼痛持续时间与左侧尾状核的GMV呈负相关。新发CBP患者右侧内嗅区、右侧杏仁核和左侧内侧前额叶皮质的GMV较少。在t1时患有BP且后来是否发展为CBP的患者之间存在差异的其他变量包括疼痛强度、体重指数和抑郁评分。总之，这些发现符合以下观点，即边缘脑特性既是CBP发展过程中的易感风险因素，也是脑重组的驱动因素。
