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Sharon Mason Palmer

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Chronic pain link to brain changes
Sunday, December 31, 2006  10:25:00 AM

by Sharon Mason Palmer

[Posted: Sat 02/12/2006]

A team of German researchers have found that people suffering from chronic low back pain, also have structural changes in their brain.

The researchers used a specialised imaging technique called diffusion tensor imaging (DTI). They believe these findings are important because 'a major problem for patients with chronic pain is making their condition believable to doctors and relatives'.

"With these objective and reproducible correlates in brain imaging, chronic pain may no longer be a subjective experience. For pain diagnosis and treatment, the consequences could be enormous", said radiologist, Dr Jürgen Lutz.

DTI tracks the movement of water molecules in the brain's grey and white matter. Individual water molecules are constantly in motion, colliding with each other and nearby molecules, causing them to spread out (diffuse). DTI allows scientists to analyse water diffusion in the tissues of the brain that indicate brain cell organisation.

Dr Lutz and his colleagues studied patients experiencing chronic back pain. In all of the cases, there were no precise identifiable causes for this pain.

Compared to healthy volunteers, the patients with chronic low back pain had significantly more directed diffusion in the three pain-processing regions of the brain.

"Our results reveal that in chronic pain sufferers, the organisation of cerebral microstructure is much more complex and active in the areas of the brain involved in pain processing, emotion and the stress response", said co-researcher, Dr Gustav Schelling.

The team believes that the findings may help to explain the extreme resistance to treatment in chronic low back pain cases and provide much needed evidence for individual sufferers. However it is still unclear which comes first, the chronic pain or the structural changes in the brain.

"It's difficult to know whether these are pre-existing changes in the brain that predispose an individual to developing chronic pain, whether ongoing pain creates the hyperactivity that actually changes the brain organisation, or if it is some mixture of both", Dr Schelling said.

DTI may help explain what is happening in some of these patients 'and direct therapeutic attention from the spine to the brain', he added.

Details of these findings were presented at the annual meeting of the Radiological Society of North America in Chicago.
Chronic pain link to brain changes

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