Changes in gray matter volume after microsurgical lumbar discectomy: a longitudinal analysis

Area of Science:

• Neuroscience
• Pain Medicine
• Neurosurgery

Background:

• Chronic lower back pain affects millions globally, with imaging often failing to correlate with perceived pain intensity.
• Growing evidence suggests central pain processing in the brain underlies pain perception, particularly when structural abnormalities are not explanatory.
• Neuroimaging techniques offer insights into brain areas involved in acute and chronic pain perception.

Purpose of the Study:

• To investigate structural brain changes in patients with chronic low back pain and sciatica due to lumbar disc herniation.
• To explore the relationship between these brain changes and preoperative pain intensity and duration.

Main Methods:

• Structural magnetic resonance imaging (MRI) of the brain was conducted on 12 patients.
• Scans were performed preoperatively and approximately 4 weeks after microsurgical lumbar discectomy.
• Analysis focused on changes in gray matter volume in specific brain regions.

Main Results:

• Post-surgery MRI showed increased gray matter volume in the basal ganglia.
• A decrease in hippocampal volume was observed post-surgery.
• Hippocampal volume changes significantly correlated with preoperative pain intensity, but not pain duration.

Conclusions:

• Structural brain changes, including alterations in the basal ganglia and hippocampus, occur in chronic low back pain patients following discectomy.
• The hippocampus's volume changes suggest a link between pain intensity, memory, and movement processing networks.
• Understanding these central pain processing alterations can inform future treatment strategies for chronic low back pain and sciatica.