This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Introduction: Complex regional pain syndrome (CRPS) is a particularly debilitating chronic neuropathic pain condition that is not well understood from a pathophysiological basis, and treatments are often ineffective. Recent evidence suggests that brain mechanisms have an important role in the generation and maintenance of many chronic pain conditions, including CRPS. Previous papers using MRI reported that chronic back pain patients showed gray matter density reduction. In this study we investigated gray matter density differences between CRPS patients and controls using voxel-based morphometry(VBM). Methods and Discussion: Nine patients (females, right handed, mean age 39.0 years, SD=9.3) meeting IASP criteria for CRPS were recruited from the Stanford University Pain Management Center. Diagnoses were made by two doctors based on a review of their charts and physical examination. Magnetic resonance imaging was performed on a GE 3.0 T scanner. A T1-weighted 3D structural MRI of the whole brain was acquired on each subject using a SPGR pulse sequence (TE 1.9ms, TI 300ms, TR 8.9s, flip angle 15, FOV 220*220*186mm3, matrix 256*256*124, thickness 1.5mm).?The slices covered the whole brain. Voxel based morphometry compares gray matter volume by using deformation between the template of the structural MRI image and the raw image obtained from the scanner. MRIcro software and SPM2 software were used to analyze the data and create the normalized segmented gray matter density images. The gray matter images were smoothed with 8mm Gausian kernel. We then did the comparison of the gray matter volume between patients and normal subjects.
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