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What does the grey matter decrease in the medial prefrontal cortex reflect in people with chronic pain?

David Kang1,2, James H McAuley1,2, Mustafa S Kassem1

  • 1Neuroscience Research Australia, Sydney, NSW, Australia.

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Chronic pain is linked to reduced grey matter in the medial prefrontal cortex, but it is not due to neurodegeneration. New research suggests biochemical and cellular changes, like dendritic alterations and neurotransmitter imbalance, cause this grey matter loss.

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Area of Science:

  • Neuroscience
  • Pain Research
  • Neuroimaging

Background:

  • Chronic pain is associated with grey matter volume alterations in brain regions.
  • A consistent finding is decreased grey matter volume in the medial prefrontal cortex (mPFC).
  • The mPFC is crucial for emotional and cognitive processing in chronic pain.

Purpose of the Study:

  • To review existing literature on the biochemical and cellular basis of mPFC grey matter volume decrease in chronic pain.
  • To explore potential non-degenerative mechanisms underlying mPFC grey matter loss.
  • To guide future research into chronic pain pathophysiology.

Main Methods:

  • Literature search conducted using PubMed and Scopus.
  • Keywords included chronic pain, medial prefrontal cortex, grey matter, neurochemistry, and neurodegeneration.
  • Review focused on biochemical and cellular explanations for grey matter changes.

Main Results:

  • Two pathways contribute to mPFC grey matter decrease under a stress model of chronic pain.
  • Pathway 1: Altered dendritic morphology due to hypothalamic-pituitary axis dysfunction.
  • Pathway 2: Neurotransmitter dysregulation (glutamate, GABA) affecting microvasculature.

Conclusions:

  • The study proposes novel mechanisms for mPFC grey matter loss in chronic pain, distinct from neurodegeneration.
  • Findings suggest biochemical and cellular changes, not neurodegeneration, are responsible for mPFC grey matter reduction.
  • This review provides a foundation for future research into the non-degenerative causes of chronic pain-related brain changes.