Gray Matter Volume Abnormality in Chronic Pain Patients With Depressive Symptoms: A Systemic Review and Meta-Analysis of Voxel-Based Morphometry Studies

Teng Ma; Yuan-Yuan Ji; Lin-Feng Yan; Jia-Ji Lin; Ze-Yang Li; Wen Wang; Jin-Lian Li; Guang-Bin Cui

doi:10.3389/fnins.2022.826759

Gray Matter Volume Abnormality in Chronic Pain Patients With Depressive Symptoms: A Systemic Review and Meta-Analysis of Voxel-Based Morphometry Studies

Front Neurosci. 2022 Jun 6:16:826759. doi: 10.3389/fnins.2022.826759. eCollection 2022.

Authors

Teng Ma¹, Yuan-Yuan Ji^{2

3}, Lin-Feng Yan¹, Jia-Ji Lin⁴, Ze-Yang Li¹, Wen Wang¹, Jin-Lian Li¹, Guang-Bin Cui¹

Affiliations

¹ Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
² College of Forensic Medicine, Xi'an Jiaotong University, Xi'an, China.
³ Key Laboratory of Ministry of Public Health for Forensic Science, Xi'an Jiaotong University, Xi'an, China.
⁴ Department of Radiology, Chinese PLA General Hospital, Beijing, China.

Abstract

Background: Gray matter volume (GMV) alteration in specific brain regions has been widely regarded as one of the most important neuroplasticity features in chronic pain patients with depressive symptoms (CP-D). However, the consistent and significant results were still lacking. Thus, further exploration was suggested to be performed.

Objectives: This study aimed to comprehensively collect the voxel-based morphometry (VBM) studies on GMV alteration between CP-D and healthy controls (HCs). And a systemic review and meta-analysis were made to explore the characteristic brain regions in chronic pain and depression comorbidity.

Methods: Search of PubMed, MEDLINE, Web of Science, and Cochrane Library databases updated to July 13, 2021. The altered GMV between CP-D and HCs in VBM studies was included in this meta-analysis. In total, 18 studies (20 datasets) and 1320 participants (520 patients and 800 HCs) were included. The significant coordinate information (x, y, z) reported in standard space and the effect size (t-value or z-score) were extracted and analyzed by anisotropic effect size-signed differential mapping (AES-SDM) 5.15 software.

Results: According to the main analysis results, CP-D showed significant and consistent increased GMV in the left hippocampus (HIP. L) and decreased GMV in the medial part of the left superior frontal gyrus (SFG. L, BA 10) compared to HCs. Subgroup analysis showed significant decreased GMV in the medial orbital part of SFG.R (BA 10) in neuropathic pain, as well as significant increased GMV in the right parahippocampal gyrus (PHG.R, BA 35), left hippocampus (HIP.L, BA 20), and right middle frontal gyrus (MFG.R) in musculoskeletal pain. Furthermore, meta-regression showed a positive relationship between the decreased GMV in the medial part of SFG.L and the percentage of female patients.

Conclusion: GMV abnormality in specific brain areas (e.g., HIP.L and SFG) was robust and reproducible, which could be significantly involved in this comorbidity disease. The findings in this study may be a valuable reference for future research.

Systematic review registration: [www.crd.york.ac.uk/prospero/].

Keywords: chronic pain; depressive symptom; gray matter volume; meta-analysis; voxel-based morphometry.

Publication types

Systematic Review