title: Reduced cortical thickness of brain areas involved in pain processing in patients with chronic pancreatitis.
abstract: OBJECTIVE
  Patients with painful chronic pancreatitis (CP) might have abnormal brain function. We assessed cortical thickness in brain areas involved in visceral pain processing.
  
  
  METHODS
  We analyzed brain morphologies of 19 patients with painful CP and compared them with 15 healthy individuals (controls) by using a 3T magnetic resonance scanner. By using an automated method with surface-based cortical segmentation, we assessed cortical thickness of the primary (SI) and secondary (SII) somatosensory cortex; prefrontal cortex (PFC); frontal cortex (FC); anterior (ACC), mid (MCC), and posterior (PCC) cingulate cortex; and insula. The occipital middle sulcus was used as a control area. The pain score was determined on the basis of the average daily amount of pain during 1 week.
  
  
  RESULTS
  Compared with controls, patients with CP had reduced overall cortical thickness (P = .0012), without effects of modification for diabetes, alcoholic etiologies, or opioid treatment (all P values >.05). In patients with CP, the cortical thickness was decreased in SII (P = .002, compared with controls), PFC (P = .046), FC (P = .0003), MCC (P = .001), and insula (P = .002). There were no differences in cortical thickness between CP patients and controls in the control area (P = .20), SI (P = .06), ACC (P = .95), or PCC (P = .42). Cortical thickness in the affected areas correlated with pain score (r = 0.47, P = .003).
  
  
  CONCLUSIONS
  In patients with CP, brain areas involved in pain processing have reduced cortical thickness. As a result of long-term, ongoing pain input to the neuromatrix, cortical thickness might serve as a measure for overall pain system dysfunction, as observed in other diseases characterized by chronic pain.
authors.affiliation: Mech-Sense, Department of Gastroenterology & Hepatology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark. jf@mech-sense.com
authors.forename: Jens Brøndum
authors.initials: JB
authors.lastname: Frøkjær
authors.forename: Stefan A W
authors.initials: SA
authors.lastname: Bouwense
authors.forename: Søren Schou
authors.initials: SS
authors.lastname: Olesen
authors.forename: Flemming H
authors.initials: FH
authors.lastname: Lundager
authors.forename: Simon F
authors.initials: SF
authors.lastname: Eskildsen
authors.forename: Harry
authors.initials: H
authors.lastname: van Goor
authors.forename: Oliver H G
authors.initials: OH
authors.lastname: Wilder-Smith
authors.forename: Asbjørn Mohr
authors.initials: AM
authors.lastname: Drewes
mesh_terms: D000328:Adult; D000368:Aged; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006805:Human Experimentation; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D050500:Pancreatitis, Chronic / Q000150:complications*; D011859:Radiography; D059265:Visceral Pain / Q000503:physiopathology*