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2016 ; 221
(2
): 1095-111
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Rapid treatment-induced brain changes in pediatric CRPS
#MMPMID25515312
Erpelding N
; Simons L
; Lebel A
; Serrano P
; Pielech M
; Prabhu S
; Becerra L
; Borsook D
Brain Struct Funct
2016[Mar]; 221
(2
): 1095-111
PMID25515312
show ga
To date, brain structure and function changes in children with complex regional
pain syndrome (CRPS) as a result of disease and treatment remain unknown. Here,
we investigated (a) gray matter (GM) differences between patients with CRPS and
healthy controls and (b) GM and functional connectivity (FC) changes in patients
following intensive interdisciplinary psychophysical pain treatment. Twenty-three
patients (13 females, 9 males; average age ± SD = 13.3 ± 2.5 years) and 21
healthy sex- and age-matched controls underwent magnetic resonance imaging.
Compared to controls, patients had reduced GM in the primary motor cortex,
premotor cortex, supplementary motor area, midcingulate cortex, orbitofrontal
cortex, dorsolateral prefrontal cortex (dlPFC), posterior cingulate cortex,
precuneus, basal ganglia, thalamus, and hippocampus. Following treatment,
patients had increased GM in the dlPFC, thalamus, basal ganglia, amygdala, and
hippocampus, and enhanced FC between the dlPFC and the periaqueductal gray, two
regions involved in descending pain modulation. Accordingly, our results provide
novel evidence for GM abnormalities in sensory, motor, emotional, cognitive, and
pain modulatory regions in children with CRPS. Furthermore, this is the first
study to demonstrate rapid treatment-induced GM and FC changes in areas
implicated in sensation, emotion, cognition, and pain modulation.
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