title: Effective treatment of chronic low back pain in humans reverses abnormal brain anatomy and function.
abstract: Chronic pain is associated with reduced brain gray matter and impaired cognitive ability. In this longitudinal study, we assessed whether neuroanatomical and functional abnormalities were reversible and dependent on treatment outcomes. We acquired MRI scans from chronic low back pain (CLBP) patients before (n = 18) and 6 months after (spine surgery or facet joint injections; n = 14) treatment. In addition, we scanned 16 healthy controls, 10 of which returned 6 months after the first visit. We performed cortical thickness analysis on structural MRI scans, and subjects performed a cognitive task during the functional MRI. We compared patients and controls, as well as patients before versus after treatment. After treatment, patients had increased cortical thickness in the left dorsolateral prefrontal cortex (DLPFC), which was thinner before treatment compared with controls. Increased DLPFC thickness correlated with the reduction of both pain and physical disability. Additionally, increased thickness in primary motor cortex was associated specifically with reduced physical disability, and right anterior insula was associated specifically with reduced pain. Left DLPFC activity during an attention-demanding cognitive task was abnormal before treatment, but normalized following treatment. These data indicate that functional and structural brain abnormalities-specifically in the left DLPFC-are reversible, suggesting that treating chronic pain can restore normal brain function in humans.
authors: Alan Edwards Centre for Research on Pain, McGill Scoliosis and Spine Research Group, McGill University, Montreal, Quebec H3A 1A4, Canada.
authors: David A
authors: DA
authors: Seminowicz
authors: Timothy H
authors: TH
authors: Wideman
authors: Lina
authors: L
authors: Naso
authors: Zeinab
authors: Z
authors: Hatami-Khoroushahi
authors: Summaya
authors: S
authors: Fallatah
authors: Mark A
authors: MA
authors: Ware
authors: Peter
authors: P
authors: Jarzem
authors: M Catherine
authors: MC
authors: Bushnell
authors: Yoram
authors: Y
authors: Shir
authors: Jean A
authors: JA
authors: Ouellet
authors: Laura S
authors: LS
authors: Stone
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