The mechanism of brain reorganization in pain chronification is unknown. In a longitudinal brain imaging study, subacute back pain (SBP) patients were followed over the course of 1 year. When pain persisted (SBPp, in contrast to recovering SBP and healthy controls), brain gray matter density decreased. Initially greater functional connectivity of nucleus accumbens with prefrontal cortex predicted pain persistence, implying that corticostriatal circuitry is causally involved in the transition from acute to chronic pain.
Department of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
Marwan N Baliki,
Kristina M Herrmann,
Lejian Huang &
A Vania Apkarian
Department of Rheumatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
Thomas J Schnitzer
Department of Neurology and the Ernest Gallo Clinic & Research Center, University of California, San Francisco, Emeryville, California, USA.
Howard L Fields
Departments of Anesthesia and Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
A Vania Apkarian
M.N.B. conducted the experiment, analyzed the data and prepared and wrote the manuscript. B.P. contributed to data collection and analysis. S.T. recruited subjects and conducted the experiment. K.M.H. contributed to data collection. L.H. performed data quality control. T.J.S. recruited subjects and edited the manuscript. H.L.F. wrote the manuscript. A.V.A. designed and supervised the experiment and wrote the manuscript.
Competing financial interests
The authors declare no competing financial interests.