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Brain structural changes in patients with chronic myofascial pain
D M Niddam1,2, S-H Lee3,4, Y-T Su5
1Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
European Journal of Pain (London, England)
|June 29, 2016
Summary
Chronic myofascial pain from trigger points is linked to brain atrophy in pain-processing areas. This brain structural change, not stress, correlates with reduced pain thresholds in patients.
Area of Science:
- Neuroscience
- Pain Research
- Musculoskeletal Disorders
Background:
- Myofascial trigger points (MTrPs) are a common cause of chronic musculoskeletal pain.
- Prolonged pain from MTrPs may alter the central nervous system, but brain atrophy links remain unclear.
- Stress is a potential factor in MTrP formation and can affect brain structures.
Purpose of the Study:
- To investigate structural brain changes in patients with chronic myofascial pain.
- To determine if these brain changes correlate with pain intensity or stress levels.
Main Methods:
- Compared grey matter (GM) volumes using voxel-based morphometry in 21 chronic pain patients with MTrPs and 21 healthy controls.
- Assessed hyperalgesia via pressure pain thresholds and stress via cortisol levels and anxiety questionnaires.
Main Results:
- Patients showed lower pain thresholds but normal stress levels.
- GM atrophy was observed in prefrontal regions and the anterior hippocampus in patients.
- Right dorsolateral prefrontal cortex GM density correlated with pain thresholds, indicating more atrophy with lower thresholds.
Conclusions:
- Chronic myofascial pain is associated with GM atrophy in brain regions crucial for pain modulation and emotional processing.
- The correlation between prefrontal cortex atrophy and pain thresholds suggests impaired pain inhibition.
- No evidence linked stress to the observed brain changes.
