Brain Connectivity Predicts Transition to Chronic Pain

More connectivity between nucleus accumbens and prefrontal cortex seen in chronic back pain

TUESDAY, July 3 (HealthDay News) -- Greater connectivity between two areas of the brain increases the likelihood that subacute back pain will not recover and will become chronic instead, according to a study published online July 1 in Nature Neuroscience.

Marwan N. Baliki, Ph.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues performed brain scans at study entry and followed pain and brain markers over a one-year period in 40 patients who previously had an episode of subacute back pain lasting four to 16 weeks.

The researchers found that, compared with patients who recovered from their pain, patients whose pain became chronic had greater connectivity between the medial prefrontal cortex (mPFC) and the nucleus accumbens (NAc), an area underlying reinforcement learning. These patients also had loss of gray matter density in the bilateral striatum and insula and in the left sensorimotor cortex. Patients with persistent pain had significantly greater positive functional connectivity in the NAc at baseline and one year. Greater functional connectivity of the NAc with the mPFC at baseline was predictive of persistent pain.

"Here we show that the corticolimbic mPFC-NAc connection is an accurate predictor of the transition from subacute to chronic pain," Baliki and colleagues conclude. "That motivation-valuation circuitry predicts pain persistence raises the intriguing possibility that, as with positive reinforcement learning, the NAc contributes to an aversive teaching signal that leads to sustained pain intensity over time following a static peripheral injury."

Abstract
Full Text (subscription or payment may be required)

Copyright © 2012 HealthDay. All rights reserved.

Powered by

Featured Jobs



Benefits of Membership

FREE E-Newsletters
Sign up for our free enewsletters to stay up-to-date in your area of practice - or take a look at an archive of prior issues

CESaver
Join our CESaver program to earn up to 100 contact hours for only $34.95
Register Now

Lippincott's NursingCenter.com
Explore a world of online resources

Become a Member