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Effective Treatment of Chronic Low Back Pain in Humans Reverses Abnormal Brain Anatomy and Function - Source: The Journal of Neuroscience, May 18, 2011

  [ 22 votes ]   [ 2 Comments ]
By David A Seminowicz, et al. • • May 18, 2011

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, [back pain] 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 [in] 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 dorsolateral prefrontal cortex - are reversible, suggesting that treating chronic pain can restore normal brain function in humans.

Source: The Journal of Neuroscience, May 18, 2011;31(20):7540-7550. By Seminowicz DA, Wideman TH, Naso L, Hatami-Khoroushahi z, Fallatah s, Ware MA, Jarzem P, Bushnell MC, Shir Y, Ouellet JA, Stone LS. McGill University, Montreal, Quebec, Canada.

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Article Comments Post a Comment

treatment options?
Posted by: Sandy10m
May 28, 2011
I find it interesting that the improvements came after spinal surgery or facet injections, two of the most invasive procedures available. I think a more prudent study would be using chiropractic and physical therapy, which are the first lines of defense against lower back pain, with surgery and injections as the absolute last resort. But, I guess it's good news that, even if you do the absolute last resort treatment, you do get some relief of memory problems.
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Partially Helpful
Posted by: Scribelle
Jun 22, 2011
It would help to mention what the dorso-lateral prefrontal cortex does. What is its function? It makes sense that a reduction of pain would affect the brain, but to understand what changes occur would help those of us in pain to cope with those changes.
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