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Brain alteration in chronic pain and the relationship with pain score

  • Endang Mutiawati ,
  • Syahrul Syahrul ,
  • Nasrul Musadir ,


Brain volume alteration in chronic pain has been studied in many studies. Most of the reviews were reported that the brain volume decrease in chronic pain, although there were some studies reported that the brain volume increased. The alteration mechanism of brain volume was certain unknown, maybe it caused by nerve hyperactivity in the pain pathway, from nociceptor to post-central gyrus. The alteration of substantia grisea volume decreased is interested to know, which it is occurring in the location of the pain pathway of substantia grisea in the brain. This mechanism was one of the body’s ways to reduce the pain score, which then it makes the painless.


  1. Martucci KT, Mackey SC. Imaging Pain. Anesthesiol Clin. 2016;34(2):255–69.
  2. Gupta A, Mayer EA, Fling C, Labus JS, Naliboff BD, Hong JY, et al. Sex-based differences in brain alterations across chronic pain conditions. Journal of Neuroscience Research. 2017;20:1-8.
  3. Yang S, Chang MC. Chronic pain: Structural and functional changes in brain structures and associated negative affective states. Int J Mol Sci. 2019;20(13):1-9.
  4. Massart R, Dymov S, Millecamps M, Suderman M, Gregoire S, Koenigs K, et al. Overlapping signatures of chronic pain in the DNA methylation landscape of prefrontal cortex and peripheral T cells. Sci Rep. 2016;6:1–13.
  5. Jason E. Pope, Deer TR. Treatment of Chronic Pain Conditions. Anesthesia & Analgesia. 2018;126:1780-88.
  6. Davis KD, Flor H, Greely HT, Iannetti GD, MacKey S, Ploner M, et al. Brain imaging tests for chronic pain: Medical, legal and ethical issues and recommendations. Nat Rev Neurol. 2017;13(10):624–38.
  7. Liao X, Mao C, Wang Y, Zhang Q, Cao D, Seminowicz DA, et al. Brain grey matter alterations in Chinese patients with chronic knee osteoarthritis pain based on voxel-based morphometry. Med (United States). 2018;97(12):1-7.
  8. Mc Mahon SB, Koltzenburg M, Ma IT, Turk DC. Wall and Melzack’s Textbook of Pain. Anaesthesia progress. 2013.
  9. Seminowicz DA, Moayedi M. The Dorsolateral Prefrontal Cortex in Acute and Chronic Pain. J Pain. 2017;22:1-8.
  10. Tatu K, Costa T, Nani A, Diano M, Quarta DG, Duca S, et al. How do morphological alterations caused by chronic pain distribute across the brain? A meta-analytic co-alteration study. NeuroImage Clin. 2018;18:15–30.
  11. Kuner R, Flor H. Structural plasticity and reorganisation in chronic pain. Nat Rev Neurosci. 2016;18(1):20–30.
  12. Saab CY. Chronic Pain and Brain Abnormalities. Chronic Pain and Brain Abnormalities. 2013;12(2):1-8.
  13. Bosma RL, Hemington KS, Davisa KD. Using magnetic resonance imaging to visualize the brain in chronic pain. Pain. 2017;158(7):1192-1201.
  14. Hotz-Boendermaker S, Marcar VL, Meier ML, Boendermaker B, Humphreys BK. Reorganization in secondary somatosensory cortex in chronic low back pain patients. Spine (Phila Pa 1976). 2016;41(11):E667–73.
  15. Hotta J, Zhou G, Harno H, Forss N, Hari R. Complex regional pain syndrome: The matter of white matter?. Brain Behav. 2017;7(5):1–8.
  16. Pujol J, Martínez-Vilavella G, Llorente-Onaindia J, Harrison BJ, López-Solà M, López-Ruiz M, et al. Brain imaging of pain sensitization in patients with knee osteoarthritis. Pain. 2017;158(9):1831–8.
  17. Yang Q, Wang Z, Yang L, Xu Y, Chen LM. Cortical thickness and functional connectivity abnormality in chronic headache and low back pain patients. Hum Brain Mapp. 2017;38(4):1815–32.
  18. Schwedt TJ, Chong CD, Wu T, Gaw N, Fu Y, Li J. Accurate classification of chronic migraine via brain magnetic resonance imaging. Headache. 2015;55(6):762–77.
  19. Farmer MA, Martucci KT, Ness TJ, et al. Brain signature and functional impact of centralized pain: a Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Network Study. Pain. 2018;158(10):1979–91.
  20. Da Silva J, Seminowicz D. Neuroimaging of pain in animal models: a review of recent literature. PAIN Reports. 2019;4(4):e732.
  21. Morton DL, Sandhu JS, Jones AKP. Brain imaging of pain: State of the art. Journal of Pain Research. 2016. 12(1):1-9.
  22. Martucci KT, Mackey SC. Role of the Prefrontal Cortex in Pain. Anesthesiol Clin. 2016;34(2):255–69.
  23. Smallwood RF, Laird AR, Ramage AE, Parkinson AL, Lewis J, Clauw DJ, et al. Structural brain anomalies and chronic pain: A quantitative meta-analysis of grey matter volume. J Pain. 2013;14(7):663–75.
  24. Huang L, Kutch JJ, Ellingson BM, Martucci KT, Harris RE, Clauw DJ, et al. Brain white matter changes associated with urological chronic pelvic pain syndrome: Multisite neuroimaging from a MAPP case-control study. Pain. 2016;157(12):2782–91.
  25. Zhong J, Chen DQ, Hung PSP, Hayes DJ, Liang KE, Davis KD, et al. Multivariate pattern classification of brain white matter connectivity predicts classic trigeminal neuralgia. Pain. 2018; 159:2076–2087.
  26. Van Riper SM, Alexander AL, Koltyn KF, Stegner AJ, Ellingson LD, Destiche DJ, et al. Cerebral white matter structure is disrupted in Gulf War Veterans with chronic musculoskeletal pain. Pain. 2017;158:2364–2375.
  27. Tian T, Guo L, Xu J, Zhang S, Shi J, Liu C, et al. Brain white matter plasticity and functional reorganization underlying the central pathogenesis of trigeminal neuralgia. Sci Rep. 2016;11:1–11.
  28. Wang Y, Cao DY, Remeniuk B, Krimmel S, Seminowicz DA, Zhang M. Altered brain structure and function associated with sensory and affective components of classic trigeminal neuralgia. Pain. 2017;158(8):1561–70.
  29. Ruscheweyh R, Wersching H, Kugel H, Sundermann B, Teuber A. Gray matter correlates of pressure pain thresholds and self-rated pain sensitivity: A voxel-based morphometry study. Pain. 2018;159(7):1359–65.
  30. Davis KD. Imaging vs quantitative sensory testing to predict chronic pain treatment outcomes. Pain. 2019;160(5):S59–65.
  31. Apkarian AV, Sosa Y, Sinty S, Levy RM, Harden RN, Parrish TB, Gitelman DR. Chronic pain is associated with decreased prefrontal and thalamic grey matter density. J Neurosci. 2004;24(46):10410-5.
  32. Draganski B, Moser T, Lummel N, Ganssbauer S, Bogdahn U, Haas F, May A. Decrease of thalamic grey matter following limb amputation. Neuroimage. 2006;31:951–957.

How to Cite

Mutiawati, E., Syahrul, S., & Musadir, N. (2020). Brain alteration in chronic pain and the relationship with pain score. Bali Medical Journal, 9(2), 461–465.




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