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      The Relationship between Structural and Functional Brain Changes and Altered Emotion and Cognition in Chronic Low Back Pain : A Systematic Review of MRI and fMRI Studies

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          Abstract

          Chronic low back pain (CLBP) is a major health issue, yet its underlying mechanisms remain unknown. Studies have demonstrated the importance of emotion and cognition in chronic pain; however, the relevant brain physiology in magnetic resonance imaging (MRI) studies are unclear in CLBP populations. Therefore, this review aimed to identify MRI brain changes and examine their potential relationship with emotional and cognitive processes in CLBP.

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          Normal cognitive aging.

          Caroline N. Harada, Marissa C. Natelson Love, Kristen L. Triebel (2013)
          Even those who do not experience dementia or mild cognitive impairment may experience subtle cognitive changes associated with aging. Normal cognitive changes can affect an older adult's everyday function and quality of life, and a better understanding of this process may help clinicians distinguish normal from disease states. This article describes the neurocognitive changes observed in normal aging, followed by a description of the structural and functional alterations seen in aging brains. Practical implications of normal cognitive aging are then discussed, followed by a discussion of what is known about factors that may mitigate age-associated cognitive decline.
          Article 0 comments Cited 620 times – based on 0 reviews     Review now
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            The neural bases of emotion regulation.

            Amit Etkin, Christian Büchel, James J Gross (2015)
            Emotions are powerful determinants of behaviour, thought and experience, and they may be regulated in various ways. Neuroimaging studies have implicated several brain regions in emotion regulation, including the ventral anterior cingulate and ventromedial prefrontal cortices, as well as the lateral prefrontal and parietal cortices. Drawing on computational approaches to value-based decision-making and reinforcement learning, we propose a unifying conceptual framework for understanding the neural bases of diverse forms of emotion regulation.
            Article 0 comments Cited 396 times – based on 0 reviews     Review now
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              Chronic back pain is associated with decreased prefrontal and thalamic gray matter density.

              A Vania Apkarian, Yamaya Sosa, Sreepadma Sonty … (2004)
              The role of the brain in chronic pain conditions remains speculative. We compared brain morphology of 26 chronic back pain (CBP) patients to matched control subjects, using magnetic resonance imaging brain scan data and automated analysis techniques. CBP patients were divided into neuropathic, exhibiting pain because of sciatic nerve damage, and non-neuropathic groups. Pain-related characteristics were correlated to morphometric measures. Neocortical gray matter volume was compared after skull normalization. Patients with CBP showed 5-11% less neocortical gray matter volume than control subjects. The magnitude of this decrease is equivalent to the gray matter volume lost in 10-20 years of normal aging. The decreased volume was related to pain duration, indicating a 1.3 cm3 loss of gray matter for every year of chronic pain. Regional gray matter density in 17 CBP patients was compared with matched controls using voxel-based morphometry and nonparametric statistics. Gray matter density was reduced in bilateral dorsolateral prefrontal cortex and right thalamus and was strongly related to pain characteristics in a pattern distinct for neuropathic and non-neuropathic CBP. Our results imply that CBP is accompanied by brain atrophy and suggest that the pathophysiology of chronic pain includes thalamocortical processes.
              Article 0 comments Cited 330 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Title: The Clinical Journal of Pain
                Abbreviated Title: The Clinical Journal of Pain
                Publisher: Ovid Technologies (Wolters Kluwer Health)
                ISSN (Print): 0749-8047
                Publication date Created: 2018
                Publication date (Print): July 2017
                Page: 1
                Article
                DOI: 10.1097/AJP.0000000000000534
                PubMed ID: 28719509
                SO-VID: 7d8c4512-90fd-4105-a946-9f5e3d7c7471
                Copyright © © 2017
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