title: Corticolimbic anatomical characteristics predetermine risk for chronic pain.
abstract: SEE TRACEY DOI101093/BRAIN/AWW147 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: Mechanisms of chronic pain remain poorly understood. We tracked brain properties in subacute back pain patients longitudinally for 3 years as they either recovered from or transitioned to chronic pain. Whole-brain comparisons indicated corticolimbic, but not pain-related circuitry, white matter connections predisposed patients to chronic pain. Intra-corticolimbic white matter connectivity analysis identified three segregated communities: dorsal medial prefrontal cortex-amygdala-accumbens, ventral medial prefrontal cortex-amygdala, and orbitofrontal cortex-amygdala-hippocampus. Higher incidence of white matter and functional connections within the dorsal medial prefrontal cortex-amygdala-accumbens circuit, as well as smaller amygdala volume, represented independent risk factors, together accounting for 60% of the variance for pain persistence. Opioid gene polymorphisms and negative mood contributed indirectly through corticolimbic anatomical factors, to risk for chronic pain. Our results imply that persistence of chronic pain is predetermined by corticolimbic neuroanatomical factors.
authors.affiliation: 1 Department of Physiology, Feinberg School of Medicine, Northwestern University 303 E. Chicago Ave., Chicago, IL 60611, USA.
authors.forename: Etienne
authors.initials: E
authors.lastname: Vachon-Presseau
authors.affiliation: 1 Department of Physiology, Feinberg School of Medicine, Northwestern University 303 E. Chicago Ave., Chicago, IL 60611, USA.
authors.forename: Pascal
authors.initials: P
authors.lastname: Tétreault
authors.affiliation: 1 Department of Physiology, Feinberg School of Medicine, Northwestern University 303 E. Chicago Ave., Chicago, IL 60611, USA.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Petre
authors.affiliation: 1 Department of Physiology, Feinberg School of Medicine, Northwestern University 303 E. Chicago Ave., Chicago, IL 60611, USA.
authors.forename: Lejian
authors.initials: L
authors.lastname: Huang
authors.affiliation: 1 Department of Physiology, Feinberg School of Medicine, Northwestern University 303 E. Chicago Ave., Chicago, IL 60611, USA.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Berger
authors.affiliation: 2 Department of Psychiatry and Neurobehavioral Sciences, University of Virginia , 2955 Ivy Rd, Suite 210, Charlottesville, VA 22903, USA.
authors.forename: Souraya
authors.initials: S
authors.lastname: Torbey
authors.affiliation: 1 Department of Physiology, Feinberg School of Medicine, Northwestern University 303 E. Chicago Ave., Chicago, IL 60611, USA.
authors.forename: Alexis T
authors.initials: AT
authors.lastname: Baria
authors.affiliation: 1 Department of Physiology, Feinberg School of Medicine, Northwestern University 303 E. Chicago Ave., Chicago, IL 60611, USA.
authors.forename: Ali R
authors.initials: AR
authors.lastname: Mansour
authors.affiliation: 3 Department of Anesthesia, Pain Management and Perioperative Medicine Dalhousie University, Halifax, NS, Canada B3H 4R2.
authors.forename: Javeria A
authors.initials: JA
authors.lastname: Hashmi
authors.affiliation: 4 Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Griffith
authors.affiliation: 5 Department of Neuroscience, Science for Life Laboratory, Uppsala University, BMC, Pob 593, 75124, Uppsala, Sweden.
authors.forename: Erika
authors.initials: E
authors.lastname: Comasco
authors.affiliation: 6 Northwestern University Feinberg School of Medicine, Departments of Physical Medicine and Rehabilitation and Internal Medicine/Rheumatology, 710 N. Lake Shore Drive, Room 1020, Chicago, IL 60611, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Schnitzer
authors.affiliation: 1 Department of Physiology, Feinberg School of Medicine, Northwestern University 303 E. Chicago Ave., Chicago, IL 60611, USA 7 Rehabilitation Istitute of Chicago, 345 E Superior St, Chicago, IL 60611, USA a-apkarian@northwestern.edu marwanbaliki2008@u.northwestern.edu.
authors.forename: Marwan N
authors.initials: MN
authors.lastname: Baliki
authors.affiliation: 1 Department of Physiology, Feinberg School of Medicine, Northwestern University 303 E. Chicago Ave., Chicago, IL 60611, USA a-apkarian@northwestern.edu marwanbaliki2008@u.northwestern.edu.
authors.forename: A Vania
authors.initials: AV
authors.lastname: Apkarian
mesh_terms: D000328:Adult; D000679:Amygdala / Q000187:drug effects / Q000503:physiopathology; D001416:Back Pain / Q000000981:diagnostic imaging / Q000503:physiopathology; D059350:Chronic Pain / Q000000981:diagnostic imaging / Q000503:physiopathology; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D059907:Functional Neuroimaging / Q000379:methods; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000000981:diagnostic imaging / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology; D012307:Risk Factors; D066127:White Matter / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: brain network; chronic pain; diffusion tensor imaging (DTI); limbic system; magnetic resonance imaging (MRI)