TY - JOUR
T1 - Progression of Structural Brain Changes in Patients With Chronic Pancreatitis and Its Association to Chronic Pain
T2 - A 7-Year Longitudinal Follow-up Study
AU - Muthulingam, Janusiya
AU - Olesen, Søren Schou
AU - Hansen, Tine Maria
AU - Seminowicz, David A
AU - Burrowes, Shana
AU - Drewes, Asbjørn Mohr
AU - Frøkjær, Jens Brøndum
PY - 2018/11/1
Y1 - 2018/11/1
N2 - OBJECTIVES: Temporal information about the structural brain changes in chronic pancreatitis (CP) and its relation to the clinical manifestations is lacking. This study investigated changes in morphological brain parameters over 7 years in painful CP patients, compared with controls.METHODS: In this 7-year longitudinal magnetic resonance imaging study, we included 23 CP patients and 14 controls. Gray matter volume (GMV) and cortical thickness were examined using voxel-based and surface-based morphometry. In addition, patients completed pain questionnaires and diary.RESULTS: At baseline, patients had reduced GMV and cortical thickness in widespread brain areas compared with controls. After 7 years of follow-up, the GMV loss was more pronounced in patients compared with controls, particularly in precentral gyrus and putamen. Moreover, an increase in pain scores was associated with a less reduction of thalamic GMV (P = 0.046), whereas an increase in brief pain inventory score was associated with more reduction in cortical thickness of precentral (P = 0.005) and superior temporal gyri (P = 0.019), indicating that brain morphological alterations are associated with the pain.CONCLUSIONS: Chronic pancreatitis pain is associated with morphological brain changes over time in several areas, reflecting that brain plasticity may be a consequence of repeated long-term nociceptive signaling.
AB - OBJECTIVES: Temporal information about the structural brain changes in chronic pancreatitis (CP) and its relation to the clinical manifestations is lacking. This study investigated changes in morphological brain parameters over 7 years in painful CP patients, compared with controls.METHODS: In this 7-year longitudinal magnetic resonance imaging study, we included 23 CP patients and 14 controls. Gray matter volume (GMV) and cortical thickness were examined using voxel-based and surface-based morphometry. In addition, patients completed pain questionnaires and diary.RESULTS: At baseline, patients had reduced GMV and cortical thickness in widespread brain areas compared with controls. After 7 years of follow-up, the GMV loss was more pronounced in patients compared with controls, particularly in precentral gyrus and putamen. Moreover, an increase in pain scores was associated with a less reduction of thalamic GMV (P = 0.046), whereas an increase in brief pain inventory score was associated with more reduction in cortical thickness of precentral (P = 0.005) and superior temporal gyri (P = 0.019), indicating that brain morphological alterations are associated with the pain.CONCLUSIONS: Chronic pancreatitis pain is associated with morphological brain changes over time in several areas, reflecting that brain plasticity may be a consequence of repeated long-term nociceptive signaling.
KW - abdominal pain
KW - brain imaging
KW - brain/gut interaction
KW - chronic pancreatitis
UR - http://www.scopus.com/inward/record.url?scp=85055079872&partnerID=8YFLogxK
U2 - 10.1097/MPA.0000000000001151
DO - 10.1097/MPA.0000000000001151
M3 - Journal article
C2 - 30211804
SN - 0885-3177
VL - 47
SP - 1267
EP - 1276
JO - Pancreas
JF - Pancreas
IS - 10
ER -