Rapid treatment-induced brain changes in pediatric CRPS
Open accessAbstract
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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A study found reduced dorsolateral prefrontal cortex gray matter volume in pediatric patients with complex regional pain syndrome, amongst other brain regions, that were reversed with treatment.
“Another study found reduced DLPFC GMV in pediatric patients with complex regional pain syndrome, amongst other brain regions, that were reversed with treatment26”
From The dorsolateral prefrontal cortex in acute and chronic pain (2017) · cites this paper as [26]
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References 152 · Cited by 108
- Authors
- Erpelding, N., Simons, L., Lebel, A., Serrano, P., Pielech, M., Prabhu, S., Becerra, L., & Borsook, D.
- Affiliations
- Boston Children's Hospital (US)
- Corresponding author
- Erpelding, Nathalie
- ORCID
- Venue
- Brain Structure and Function
- Published
- 2014-12-17
- Volume
- 221
- Issue
- 2
- Pages
- 1095-1111
- ISSN
- 1863-2653 (ISSN-L)
- 1863-2661
- PMC
- PMC4470894
- OpenAlex
- W2094161619
- Cited by
- 108
- References
- 152
- Citations by year
- 2026: 8 · 2025: 2 · 2024: 8 · 2023: 7 · 2022: 10 · 2021: 16 · 2020: 13 · 2019: 14 · 2018: 9 · 2017: 10 · 2016: 7 · 2015: 3 · 2013: 1
- FWCI
- 9.13
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Brain Structure and Function (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- MAYDAY Fund
- National Institutes of Health (5r01ns065051-02)
- National Institute of Neurological Disorders and Stroke (R01-NS-065051, K24NS064050)
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD067202, HD067202)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- complex regional pain syndrome, pediatric CRPS, gray matter changes, functional connectivity, descending pain modulation, periaqueductal gray, dorsolateral prefrontal cortex, thalamus, basal ganglia, hippocampus, amygdala
- MeSH terms
- Adolescent, Amygdala, Basal Ganglia, Brain, Child, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Motor Cortex, Pain, Parietal Lobe, Case-Control Studies, Prefrontal Cortex, Complex Regional Pain Syndromes, Connectome, Gray Matter
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