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The Relationship of Brain Structure to Chronic Pain

Neuroscientists at Northwestern University Feinberg School of Medicine have discovered a relationship between an individual's brain structure and chronic pain. Their research studied 40 people with new back injuries and found they could predict, with 85% accuracy which of those individuals would develop chronic pain and which would have pain resolution. 

Recognizing that two different people often have very different outcomes from very similar injuries, the physicians studied the patients individual brain structures at the start of the study and several times during a period of one year. After dividing the patients into two groups, those whose pain was persisting and those whose pain was subsiding, they then studied physical structures within the brains of the two groups.

The studies revealed that there were two key brain regions which were different in the groups. Those with greater connections between the nucleus accumbens and the medial prefrontal cortex were more likely to develop issues with chronic pain from their initial injuries. Those with less connections between these regions were more likely to recover in less time.

The results, published in the journal Nature Neuroscience, provide a physical reason certain people are predisposed to developing chronic pain issues while others recover quicker. Defense medical witnesses often opine that if a person does not recover from certain types of injuries (including back injuries) within a certain time frame, it is due to malingering or people faking their injuries to enhance their legal claims. The research of neuroscientist A. Vania Apkarian, M.D. and others involved in the studies will help explain to juries how such testimony is not based on advanced medical research.

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