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Brain activity associated with chronic cancer pain
Asokumar Buvanendran1, Amjad Ali, Travis R Stoub
1Department of Anesthesiology, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612, USA. Asokumar@aol.com
Pain Physician
|September 23, 2010
Summary
Cancer patients with chronic pain show increased brain activity in the prefrontal cortex compared to those without pain. This neuroimaging study used positron emission tomography (PET) to reveal differences in brain metabolism associated with pain perception.
Area of Science:
- Neuroimaging
- Oncology
- Pain Medicine
Background:
- Neuroimaging studies on chronic pain are limited.
- Chronic pain conditions activate diverse brain regions.
- Understanding brain activity in cancer pain is crucial.
Purpose of the Study:
- To compare brain activity in cancer patients with moderate-to-severe chronic pain versus no pain.
- To investigate differences in glucose metabolism using PET scans.
- To identify brain regions affected by chronic pain in cancer patients.
Main Methods:
- Prospective, observational study at an academic medical center.
- Positron emission tomography (PET) scans with 18F-fluoro-2-deoxyglucose (FDG).
- Coregistration, normalization, and statistical comparison of regional glucose metabolism between pain and no-pain groups.
Main Results:
- Patients with moderate-to-severe pain (NRS=4.5) exhibited significantly higher glucose metabolism than those with no pain (NRS=0).
- Increased metabolism was observed bilaterally in the prefrontal cortex (BA 9-11) and unilaterally in the right parietal precuneus cortex (BA 7).
- No brain areas showed decreased activity due to moderate-to-severe pain.
Conclusions:
- Preferential activation of the prefrontal cortex in chronic pain is consistent with the role of affective pain perception.
- Negative emotions may significantly contribute to the chronic pain experience.
- Study limitations include non-randomization and uncontrolled patient medication.
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