Abstract Vania Apkarian

Evidence will be presented that the brain reorganizes with chronic pain.
1) Brain activity for pain representation engages distinct regions for acute and chronic pain, and distinct types of chronic pain show specific brain activity signatures.
2) Brain anatomy reorganizes with chronic pain, and the pattern of reorganization is unique for distinct chronic pain conditions.
To determine the causal relationship between brain reorganization and chronic pain we conducted a longitudinal study where brain anatomy and function was tracked as patients with an acute episode of back pain transitioned either to chronic pain or to recovery. Brain anatomical and functional properties in these subjects show that functional properties of the corticolimbic circuitry predict pain chronification and causally relate to brain anatomical changes. The implications of these findings regarding brain information coding and regarding clinical treatments for chronic pain will be discussed.