Brain metabolic alterations in individuals with chronic non-specific neck pain assessed using proton magnetic resonance spectroscopy

TL;DR

This study uses brain scans to find metabolic changes in people with chronic neck pain, linking these changes to pain severity and duration.

Contribution

The study identifies specific brain metabolite alterations in chronic non-specific neck pain using proton magnetic resonance spectroscopy.

Findings

Decreased myo-inositol and N-acetylaspartate levels were found in pain-related brain regions of individuals with neck pain.

Altered metabolite levels correlated with pain intensity, duration, and disability in chronic neck pain patients.

Increased choline levels in the somatosensory cortex were observed in individuals with chronic neck pain.

Abstract

Altered brain metabolites in pain-related regions provide insights into the underlying mechanisms of chronic pain. However, brain metabolites alterations in chronic non-specific neck pain remain unknown. This study aimed to investigate brain metabolite concentrations in individuals with chronic non-specific neck pain and their relationships with pain-related outcomes. Participants included 30 individuals with chronic non-specific neck pain and 30 pain-free controls. Absolute concentrations and metabolite ratios of total creatine (tCr), choline (Cho), myo-inositol (mI), N-acetylaspartate (NAA) and glutamate/glutamine (Glx) were measured in regions involved in pain processing and modulation, including dorsolateral prefrontal cortex (DLPFC), primary somatosensory cortex (S1), insula and thalamus, using proton magnetic resonance spectroscopy (1H-MRS). Compared to controls, participants with neck pain exhibited decreased mI and mI/tCr (left DLPFC and thalamus), NAA and NAA/tCr (right S1) and Glx and Glx/tCr (right DLPFC) and increased Cho and Cho/tCr (left S1) (adjusted p-values < 0.05). Altered metabolite levels were correlated with pain duration, intensity, extent, disability and PPT at C2-3 (r ranged from − 0.48 to 0.55, adjusted p-values < 0.05). The results suggest that ¹H-MRS detects altered levels of mI, NAA, Glx and Cho in specific brain regions involved in pain regulation, which may contribute to the persistence of neck pain.

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