Interhemispheric and Corticothalamic White-Matter Dysfunction Underlies Affective Morbidity and Impaired Pain Modulation in Chronic Pain
Authors' conclusion
Patients with chronic pain showed dysfunction of the white matter concerned with interhemispheric communication of sensorimotor information as well as descending corticothalamic modulation of pain in association with affective morbidity and altered temporal dynamics of pain perception.
Study context
- Population
- Patients with chronic pain and age- and gender-matched healthy controls
- Participants
- 26 vs 18
- Comparison
- Patients with chronic pain vs healthy controls
- Patientsn = 26
- Controlsn = 18reference
- Outcome
- White-matter alterations (FA and RD on diffusion tensor imaging (DTI)) and offset analgesia (OA) pain modulatory responses
Methodological detailsage- and gender-matched controls, diffusion tensor imaging, tract-based spatial statistics
- Age- and gender-matched controls
- Diffusion tensor imaging
- Tract-based spatial statistics
Main finding
As reported in the abstract
- Maximum VAS latency during offset analgesia (OA) (s, mean ± SD), patients vs controls: 16.0 ± 3.7 vs 18.9 ± 3.1
- P = .032
- OA latency (s, mean ± SD), patients vs controls: 15.6 ± 3.5 vs 11.1 ± 4.2
- P = .004
- Mean fractional anisotropy (FA) of global white matter, patients vs controls: 0.44 ± 0.12 vs 0.45 ± 0.11
- P = .012
- Mean radial diffusivity (RD) of global white matter, patients vs controls: 0.00057 ± 0.00002 vs 0.00056 ± 0.00002
- P = .038
Observational data: associations, not effects.
Further findings
Correlations of white-matter indices with OA latencies and catastrophizing
- FA of splenium of corpus callosum vs maximum VAS latency (r)
- 0.493
- FA of splenium of corpus callosum vs OA latency (r)
- −0.552
- Pain Catastrophizing Scale scores vs FA across those areas (r)
- −0.405
Discrimination of patients from controls (ROC analysis)
- OA latencies and white-matter metrics distinguished patients from controls
- P < 0.05
Original publication
Interhemispheric and Corticothalamic White-Matter Dysfunction Underlies Affective Morbidity and Impaired Pain Modulation in Chronic Pain. Anesth Analg. Published 5 June 2024. doi:10.
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