Our results demonstrate regionally specific reduced gray matter in patients with CBP. At the whole-brain level, this reduction is related to pain duration, regionally depends on multiple painrelated characteristics, and is more severe in the neuropathic subtype.
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We did not distinguish the source of CBP, which may be caused by various etiologies, such as fracture, inflammatory joint disease, postsurgical factors, combinations of these, or idiopathic factors (Deyo and Weinstein, 2001).
Subjects. We compared 26 CBP patients with 26 matched normal volunteers,
after obtaining informed consent. Patients fulfilled the International Association for the Study of Pain (IASP) criteria for CBP (Merskey and Bogduk, 1994) and were diagnosed in accordance with recent guidelines (Deyo and Weinstein, 2001). Diagnosis was performed by experienced clinicians (R.M.L., R.N.H.) based on history, general physical
exam, and detailed neurological exam, especially sensory, motor, reflex, and gait examinations. Briefly, all CBP patients had unrelenting pain for 1 year, primarily localized to the lumbosacral region, including buttocks and thighs, with or without pain radiating to the leg. Some CBP patients also indicated presence of pain outside this region (for example, in the upper back); they were considered to have CBP only if the main source of pain was lumbosacral.
