443: Morphometric analysis of brain structures in patients with chronic cervical pain syndrome

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic primary musculoskeletal pain, Assessment and Measurement of Pain/Nociception, Physiotherapy, Imaging (e.g. fMRI, PET, MRS)

Background and Aims: A reduction in gray matter volume is common in patients with chronic back pain, and different types of pain are associated with gray matter abnormalities in distinct brain regions. The objective is to examine differences in brain morphology in patients with cervical back pain. We investigated changes in gray matter volume using voxel-based morphometry.

Methods: We included 59 subjects with chronic pain in the neck in the study. Also, 78 healthy controls (HC) were included. We have conducted on patients a numeric rating scale (NRS) for assessing the quantity of pain, the Hamilton Scale for the Assessment of Anxiety (HAM-A), and Depression (HAM-D).

Results: The total volume of gray matter in HC was 589±45cm3 and in patients 550±58cm3 (p<0.05). The total volume of white matter in the HC was 620±77 cm3, and in patients with chronic pain, 582±74 cm3 (p<0.05). Statistically significant reductions were observed in several pain-related cortical structures in patients with chronic pain. In subcortical structures, an increase in the volume of gray matter in patients with chronic pain was observed in the putamen, in the globus pallidum, caudate nuclei, as well as in the amygdala (p < 0.05).

Conclusions: Morphometric radiological analysis showed that the volume of gray and white matter in HC was higher compared to patients with chronic neck pain. In patients with chronic pain, a decrease in brain mass volume was observed in some brain regions. Morphometric radiological analysis did not show significant differences in relation to the examined sociodemographic and clinical correlates. The volume of gray matter in the insular cortex negatively correlates with the intensity of clinical pain (rho=0.183, p<0.01), disability (rho=0.292, p<0.05), and the results on the HAM-A (rho=0.443, p<0.05) and HAM-D (rho=0.412, p<0.05).

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Presenting Author: Stojanov Aleksandar
Submitting Author: ALEKSANDAR STOJANOV

Senior Author: Stojanov Aleksandar

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Kalinic Sreten: MD - Neurology Clinic Nis
• DJordjevic Gordana: MD, PhD - Neurology Clinic Nis
• Stojanov Jelena: MD - Center for Mental Health Nis