129 Chronic Pain and Advanced MRI Techniques

Abstract

Abstract INTRODUCTION Chronic Pain is a difficult entity to define and treat. The usual definition is that of pain that persists beyond expected healing period of 3–6 months. The pathophysiology, in particular changing neural connections, are still not widely agreed on. In recent years neuroimaging has shown evidence of structural reorganization and change. These new developments can further improve understanding of the brains plasticity and potentially new strategies to either help identify those experiencing acute pain at risk of transition to chronic pain, but also as a potential target for therapy. METHODS The study population of 67 patients includes: a group of 26 selected from a pain management service and a group of 41 normal controls. The participants were matched on age, gender and ethnicity. Each patient has undergone structural and diffusion-weighted MRI scans. Voxel based morphometry was used to investigate differences in grey matter volumes between the groups, as well as to investigate correlations with neurocognitive outcomes. Cortical thickness was also calculated. Tract-based spatial statistics (TBSS) were used to investigate differences and correlation with neurocognitive outcomes between diffusion metrics (fractional anisotropy, mean diffusivity). RESULTS >The chronic pain group showed smaller cerebellar grey matter volume relative to healthy controls. There was no difference in cortical thickness observed. Furthermore, those experiencing chronic pain exhibited significantly decreased FA and increased MD in multiple white matter tracts, relative to controls. CONCLUSION These findings suggest that cerebellar atrophy maybe involved in chronic pain.