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Author Spotlight: Methodologies and Advancements of Chronic Pain Management Research
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Gray Matter Abnormalities in Patients with Chronic Primary Pain: A Coordinate-Based Meta-Analysis
Zuxing Wang1, Minlan Yuan2, Jun Xiao1
1Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China; Key Laboratory of psychosomatic medicine, Chinese Academy of Medical Sciences, Chengdu, China.
Pain Physician
|January 20, 2022
Summary
This meta-analysis found gray matter reductions in the anterior cingulate and insula in chronic primary pain (CPP) patients. Longer pain duration correlated with altered gray matter in specific brain regions, impacting treatment.
Area of Science:
- Neuroimaging
- Neuroscience
- Pain Research
Background:
- Chronic primary pain (CPP) is associated with inconsistent findings in structural MRI studies using voxel-based morphometry (VBM).
- Previous VBM studies have not definitively identified gray matter abnormalities in CPP patients.
Purpose of the Study:
- To identify gray matter differences between CPP patients (including females) and healthy controls.
- To investigate the impact of symptom duration and pain scores on gray matter in CPP.
Main Methods:
- A comprehensive meta-analysis of VBM studies published between November 2005 and June 2020.
- Inclusion of studies comparing adult CPP patients to healthy controls, with results reported in standard coordinates.
- Application of anisotropic effect-size signed differential mapping for voxel-based meta-analyses.
Main Results:
- CPP patients exhibited reduced gray matter in the left anterior cingulate, right median cingulate, and bilateral insula, with increased gray matter in the right striatum.
- Female CPP patients showed decreased gray matter in the left anterior cingulate gyrus.
- Meta-regression indicated a positive association between pain duration and a right brain region, and negative associations in the right anterior cingulate and right middle frontal gyrus.
Conclusions:
- Structural MRI reveals distinct gray matter changes in CPP patients, particularly in females.
- The chronicity of pain influences specific brain regions, potentially complicating treatment and interacting with affective disorders.
- Further large-scale, longitudinal studies are needed to confirm these findings and explore gender-specific differences in CPP.
