Brain scans predict chronic back pain

Brain scans could reveal whether a patient will develop chronic back pain. In a recent study, brain scans taken early in the course of low-back pain predicted chronicity with 85% accuracy.

This is the first time scientists can look at two patients with the same injury and predict who will suffer from chronic pain, neuroscientist Vania Apkarian told Science Now.

Researchers took brain scans of 39 patients with moderate to severe back pain. For a year after the initial tests, researchers took four additional brain scans and tracked patients' pain levels.

Although 20 patients recovered, 19 continued to suffer from persistent pain. Those patients had altered activity in the parts of the brain involved in learning and emotional responses, called the insula and the nucleus accumbens. This suggests that how these regions of the brain interact with one another could contribute to chronic pain. The communication between two regions could also influence how the brain reorganizes itself after an injury. Researchers pointed out that more of the brain is involved in responding to pain than the region directly associated with sensing it.

With new research demonstrating that back pain becomes chronic for the majority of patients,  this study could have important implications for preventing persistent pain.If doctors can detect with relative accuracy who is at risk for chronicity, they could alter the course of treatment accordingly. For now though, scientists have more research to do before brain scans are readily used in diagnosing back pain.

Reference

Baliki M, Petre B, Torbey S, et al. Corticostriatal functional connectivity predicts transition to chronic back pain. Nature Neuroscience 2012; doi:10.1038/nn.3153.