The comparison of neuroimaging characteristics of chronic pain in migraine to chronic low back pain through functional MRI

Abstract

Introduction: Despite the high frequency of migraineurs in the general population, the pathogenesis of this disorder is still unclear. There is a great need for a better understanding of the mechanisms underlying the pain, the accompanying symptoms, as well as the premonitory symptoms and the aura. Purpose and objectives: Highlighting the clinical and clinical-neuroimagistic correlations in patients with chronic migraine and chronic back pain and to prove that chronic pain causes morphological and functional changes that occur in the brain. Materials and Methods: The choice of methods and interpretation of results is guided by recent neuroimagstical research (functional MRI) that expounds on the involvement of different neural systems and brain structures in the pathophysiology o f migraine. In the current research we are taking into account the latest results of neuro-imaging studies in recent years, published in international literature, which proves the presence of structural and functional brain changes in patients with chronic pain. Results: All studies regarding chronic pain suggests that central plasticity concept is the way in which we can understand chronic pain, demonstrated in vivo using functional imaging. MRI demonstrated a loss of gray matter in patients with chronic pain (taking into account age and sex), some studies have shown that structural lesions occur in specific areas, these changes were different for different syndromes but the process of cortical reorganization was the same. Remember that the most common locations of the lessions that occur in chronic pain are: cingulate cortex, orbitofrontal, insular, dorsal-side deck, thalamus, suggesting a common basis. So we're talking about a system that is not isolated but that correlates and is influenced by the level and spinal nociceptive system. In future, studies should take into account that plasticity is the dynamic interaction of nociceptors and higher cognitive functions, immune system, endothelial cells and fields receptive. There is no evidence to conclude that the injuries are caused or are a consequence of chronic pain, but it constantly suggests that morphological changes are determined by constant pain. Conclusion: Advanced neuroimaging methods have helped us to unravel a new understanding of how chronic pain alters brain structure, function, and neurochemistry. The altered structure and function of selected brain structures, could constitute a basis for new diagnostic strategies and a measure of therapeutic efficacy.