Neurochemical analysis of primary motor cortex in chronic low back pain

Neena K. Sharma, William M. Brooks, Anda E. Popescu, Linda VanDillen, Steven Z. George, Kenneth E. McCarson, Byron J. Gajewski, Patrick Gorman, Carmen M. Cirstea

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


The involvement of the primary motor cortex (M1) in chronic low back pain (LBP) is a relatively new concept. Decreased M1 excitability and an analgesic effect after M1 stimulation have been recently reported. However, the neurochemical changes underlying these functional M1 changes are unknown. The current study investigated whether neurochemicals specific to neurons and glial cells in both right and left M1 are altered. N-Acetylaspartate (NAA) and myo-inositol (mI) were measured with proton magnetic resonance spectroscopy in 19 subjects with chronic LBP and 14 healthy controls. We also examined correlations among neurochemicals within and between M1 and relationships between neurochemical concentrations and clinical features of pain. Right M1 NAA was lower in subjects with LBP compared to controls (p = 0.008). Left M1 NAA and mI were not significantly different between LBP and control groups. Correlations between neurochemical concentrations across M1s were different between groups (p = 0.008). There were no significant correlations between M1 neurochemicals and pain characteristics. These findings provide preliminary evidence of neuronal depression and altered neuronalglial interactions across M1 in chronic LBP.

Original languageEnglish
Pages (from-to)319-331
Number of pages13
JournalBrain Sciences
Issue number3
StatePublished - Sep 2012


  • Chronic low back pain
  • Magnetic resonance spectroscopy
  • Myo-inositol
  • N-acetylaspartate
  • Primary motor cortex


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