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Dissociating anxiety from pain: mapping the neuronal marker N-acetyl aspartate to perception distinguishes closely interrelated characteristics of chronic pain

Molecular Psychiatry volume 6, pages 256–258 (2001)Cite this article

SIR – The notion that human cognitive-perceptual states are a reflection of brain chemistry is a fundamental assumption in neuroscience. However, a direct correspondence between these two domains has not been shown. Here we demonstrate distinct mappings between brain chemistry and cognitive-perceptual properties of chronic pain. By examining brain regional variations of the neuronal marker N-acetyl aspartate (NAA), we identify distinct relationships between regional variations in brain NAA and the characteristics of pain and of anxiety from which such chronic back pain patients suffer.

Most studies of pain, especially regarding chronic pain, agree that anxiety and pain are interrelated. However, the neurobiology of their relationship remains unknown, and there is no knowledge about the brain regions that may distinguish between them. We used proton magnetic resonance spectroscopy (1H-MRS) to measure levels of NAA (the dominant peak in 1H-MR spectra) in multiple brain regions,1 and correlated these levels with perceptual measures of pain as identified by the short form of the McGill Pain Questionnaire (SF-MPQ)2 and with perceptual measures of anxiety as measured by the State-Trait Anxiety Inventory (STAI).3 We analyzed these relationships in chronic back pain patients (n = 9, mean age = 45 ± 6 years) and in age- and sex-matched healthy volunteers (n = 16, mean age = 44 ± 3 years), where 1H-MRS measures were done in the orbital frontal cortex (OFC), cingulate, dorsolateral prefrontal cortex (DLPFC) and thalamus of the left hemisphere (all subjects were right-handed).

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Authors and Affiliations

  1. Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, 13210, New York, USA

    I D Grachev

  2. Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, 13210, New York, USA

    I D Grachev

  3. Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, 13210, New York, USA

    B E Fredickson

  4. Department of Physiology, Northwestern University Medical School, Chicago, 60611, IL, USA

    A V Apkarian

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  1. I D Grachev
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  2. B E Fredickson
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  3. A V Apkarian
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Correspondence to I D Grachev.

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Grachev, I., Fredickson, B. & Apkarian, A. Dissociating anxiety from pain: mapping the neuronal marker N-acetyl aspartate to perception distinguishes closely interrelated characteristics of chronic pain. Mol Psychiatry 6, 256–258 (2001). https://doi.org/10.1038/sj.mp.4000834

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