What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Depression and Chronic Pain (Somatoform Pain Disorder) (n=125). Intervention: Chronic pain and Depression vs. Healthy controls. Primary outcome: Regional homogeneity (ReHo) and functional connectivity in the resting state (p=<0.05).

June 1, 2017Open Access

Regional brain functions in the resting state indicative of potential differences between depression and chronic pain

Q: What are the key findings of this study?

Patients with chronic pain exhibited significantly decreased regional homogeneity in the dorsolateral prefrontal cortex and reduced functional connectivity between the DLPFC and thalamus compared to patients with depression and healthy controls.

AYAtsuo YoshinoHiroshima University YOYasumasa OkamotoDokkyo University MDMitsuru DoiHiroshima University

Key Result

Patients with chronic pain exhibited significantly decreased regional homogeneity in the dorsolateral prefrontal cortex and reduced functional connectivity between the DLPFC and thalamus compared to patients with depression and healthy controls.

Study Design

Type

Cross-Sectional (n=125)

Multicenter

Structured PICO

Population

125 Japanese participants, including 43 with major depressive disorder, 41 with chronic pain, and 41 healthy controls, underwent resting-state fMRI to compare regional brain functions.

Outcome

Regional homogeneity (ReHo) values and functional connectivity in the resting statesurrogate

Chronic pain and depression exhibit distinct resting-state brain functions, with chronic pain specifically associated with decreased regional homogeneity in the dorsolateral prefrontal cortex and reduced functional connectivity with the thalamus.

Main Result

p-value: p=<0.05

Limitations

Exclusion criteria did not account for all possible treatment effects, such as the use of antidepressants.
Clinical characteristics such as pain perception and anxiety were not assessed.
Patients with comorbid depression and chronic pain were excluded, limiting generalizability and clinical relevance.

Abstract

Complex relationships between depression and chronic pain have been reported in previous studies. However, only a few neuroimaging studies have investigated similarities and differences in neural systems underlying them. We examined the brain functions in the resting state of 43 patients with depression, 41 patients with chronic pain (somatoform pain disorder) and 41 healthy controls, by using regional homogeneity (ReHo) and functional connectivity analysis. Depressive symptoms were assessed by using the Beck Depression Inventory-Second Edition (BDI-II). ReHo values for the dorsolateral prefrontal cortex (DLPFC) significantly decreased for chronic pain patients, and functional connectivity between the DLPFC and thalamus decreased only for these patients. These findings are indicative of distinct brain functions related to depression and chronic pain. Understanding these differences would further elucidate the pathophysiology of these conditions.

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