Structural brain alterations in chronic primary pain: a multimodal MRI study
DOKPE
- Häuselmann, Salome ORCID University of Bern
- Wyss, Anna University of Bern
- Bischoff, Nina University of Bern
- Bruckmaier, Rupert ORCID University of Bern
- Gross, Josef ORCID University of Bern
- Berna, Chantal University of Lausanne
- grosse Holtforth, Martin University of Bern
- Aybek, Selma ORCID University of Fribourg
- Gninenko, Nicolas ORCID University of Fribourg
- 2026
Published in:
- NeuroImage: Clinical. - Elsevier BV. - 2026, vol. 51, p. 104023
Chronic primary pain
Cortical thickness
Fractal dimension
Gyrification
Structural connectivity
Sulcal depth
Surface-based morphometry
English
Chronic primary pain (CPP) occurs without an identifiable causal disease and is characterized by persistent pain,
emotional distress and functional impairment. Persistent pain may be accompanied by structural brain alterations
linked to chronification. We investigated cortical surface morphometry and structural connectivity in CPP
and explored associations with related biopsychosocial characteristics.
Thirty patients with CPP and 30 matched healthy controls (HCs) underwent psychometric assessment, pain
sensitivity testing, salivary sampling (cortisol, α-amylase), and MRI (T1-weighted, diffusion-weighted imaging
(DWI)). Surface-based morphometry features (SBM) were estimated from T1-weighted data across multiple brain
parcellations. DWI was used to reconstruct weighted structural connectomes via probabilistic tractography and
to compute node-level graph-theoretical metrics. Partial least squares correlation (PLSC) assessed multivariate
associations between imaging metrics and biopsychosocial characteristics.
Compared with HCs, CPP patients showed focal cortical alterations dominated by folding-related features
consistent across different brain parcellation schemes: increased gyrification in left prefrontal regions; reduced
sulcal depth in right lateral frontal and orbitofrontal and right medial temporo-occipital regions; and reduced
fractal dimension in posterior cingulate regions. Structural connectivity metrics showed only trend-level group
differences that did not survive correction for multiple comparisons.
PLSC revealed significant covariation between distributed SBM patterns and biopsychosocial characteristics,
including perceived stress, childhood trauma, and α-amylase concentration, mainly expressed in HCs, linking
stress-related features to profiles of gyrification, sulcal depth, and fractal dimension. These findings suggest that
cortical surface morphology may be structurally altered in patients with CPP and encourage further longitudinal
studies.
emotional distress and functional impairment. Persistent pain may be accompanied by structural brain alterations
linked to chronification. We investigated cortical surface morphometry and structural connectivity in CPP
and explored associations with related biopsychosocial characteristics.
Thirty patients with CPP and 30 matched healthy controls (HCs) underwent psychometric assessment, pain
sensitivity testing, salivary sampling (cortisol, α-amylase), and MRI (T1-weighted, diffusion-weighted imaging
(DWI)). Surface-based morphometry features (SBM) were estimated from T1-weighted data across multiple brain
parcellations. DWI was used to reconstruct weighted structural connectomes via probabilistic tractography and
to compute node-level graph-theoretical metrics. Partial least squares correlation (PLSC) assessed multivariate
associations between imaging metrics and biopsychosocial characteristics.
Compared with HCs, CPP patients showed focal cortical alterations dominated by folding-related features
consistent across different brain parcellation schemes: increased gyrification in left prefrontal regions; reduced
sulcal depth in right lateral frontal and orbitofrontal and right medial temporo-occipital regions; and reduced
fractal dimension in posterior cingulate regions. Structural connectivity metrics showed only trend-level group
differences that did not survive correction for multiple comparisons.
PLSC revealed significant covariation between distributed SBM patterns and biopsychosocial characteristics,
including perceived stress, childhood trauma, and α-amylase concentration, mainly expressed in HCs, linking
stress-related features to profiles of gyrification, sulcal depth, and fractal dimension. These findings suggest that
cortical surface morphology may be structurally altered in patients with CPP and encourage further longitudinal
studies.
- Faculty
- Faculté des sciences et de médecine
- Department
- Section de médecine
- Language
-
- English
- Classification
- Pathology, clinical medicine
- Other electronic version
- License
-
CC BY
- Open access status
- gold
- Identifiers
-
- DOI 10.1016/j.nicl.2026.104023
- ISSN 2213-1582
- Persistent URL
- https://folia.unifr.ch/unifr/documents/336572
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