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Chronic Pain changes the brain. On the functional activation level an increase in cortical excitability and an increase in cortical activation (primary sensorimotor cortex (M1/S1), anterior insula, and anterior cingulate cortex (ACC) during movement of the affected body part) could be verified especially for neuropathic pain (e.g. complex regional pain syndrome; CRPS) but also partially for other pain syndromes (e.g., craniomandibular dysfunction; CMD). For neuropathic pain this had been related to altered thalamo (Th) - cortical GABA availability. On the structural level a decrease in grey matter volume (GMV) had been demonstrated in a number of different pain syndromes (CMD, head pain, low back pain) especially in the ACC. This interacts with increased stress, increase of cigarette smoking, decreased sleeping times, increased body mass index (BMI) but inversely with the years spent with education (school, University; see glass brains on the left side of the figure). Other brain areas showing a reduction of GMV are the thalamus (for CRPS) and the anterior insula (for low back pain). On the right covariates of a population based cohort (SHIP-cohorts) for a VBM-analysis is plotted.

31.08.2021: Neuer Artikel zur Veränderung der grauen Substanz des Gehirns bei chronischen Schmerzen durch das komplexe regionale Schmerzsyndrom (CRPS) in Frontiers in Neurology: Domin M.*, Strauss S.*, McAuley J.H., Lotze M. (2021) Complex regional pain syndrome: thalamic GMV atrophy and associations of lower GMV with clinical and sensorimotor performance data. *equal contribution.

12.08.2021: Neuer Artikel zur Erfassung von Biomarkern in einer Wartelistenkontrollstudie mit graded motor imagery Therapie bei Patienten mit CRPS in Brain Communications: Strauss S., Barby S., Härtner J., Pfannmöller J., Neumann N., Moseley G.L., Lotze M. (2021) Graded motor imagery modifies movement pain, cortical excitability and sensorimotor function in CRPS.

29.12.2020: Neuer Artikel zur Funktionellen Bildgebung bei CRPS: Strauss S., Barby S., Härtner J., Neumann N., Moseley G.L., Lotze M. (2021) Modifications in fMRI representation of mental rotation following a 6 week graded motor imagery training in chronic CRPS patients. Journal of Pain, accepted.

Most discussed contribution of our group in social media on chronic back pain and alterations of the brains grey mater volume: Fritz, H.C., McAuley, J.H., Wittfeld, K., Hegenscheid, K., Schmidt, C.O., Langner, S., Lotze, M. (2015) Chronic back pain is associated with decreased prefrontal and anterior insular gray matter. Results from a population-based cohort study.


2.4.2019: Förderung durch die Else Kröner Fresenius Stiftung für unsere Studie "Grundlagen des CRPS und deren Modulierbarkeit durch innovative Therapien" (S. Strauss) für 24 Monate

21.2.2017: Domagk Stipendium für Dr. Sebastian Strauss ab 2019 für 12 Monate zur CRPS-Studie

9_2016: Neuer Blog in "Body and Mind" zur Studie von Flavia DiPietro zu veränderter S1-Repräsentation bei Patienten mit CRPS:
www.bodyinmind.org/healthy-hand-crps-brain/

Zu neuropathischen Schmerzen:
Landmann G, Lotze M. (2016) Neuropathische Schmerzen nach Querschnittlähmung. Neuroreha; 8: 117–121.
Lotze M. (2015) Maladaptive Plastizität bei chronisch neuropathischen Schmerzen; Der Schmerz, 30(2):127-133.

Veränderung der grauen Substanz bei chronischem Rückenschmerz: Fritz, H.C., McAuley, J.H., Wittfeld, K., Hegenscheid, K., Schmidt, C.O., Langner, S., Lotze, M. (2015) Chronic back pain is associated with decreased prefrontal and anterior insular gray matter. Results from a population-based cohort study. Journal of Pain, 17(1):111-8.

Publikation zur Modulation der verminderten kortikalen Inhibition bei CRPS in Pain: Strauß S, Grothe M, Usichenko T, Neumann N, Byblow WD, Lotze M. (2015) Inhibition of the primary sensorimotor cortex by topical anesthesia of the forearm in patients with CRPS. Pain, 156(12):2556-61.

Derzeit laufende Studien:
CRPS Typ I Studie: Wir untersuchen Veränderungen der cerebralen Repräsentation und der Intrakortikalen Inhibition im Handareal (Dr. Sebastian Strauss).
Voxel-based-Morphometry bei SHIP Daten: Veränderung der Hirnstruktur nach chronischen Schmerzen (H-Christian Fritz (Rückenschmerz), Nikolai Grimm (CMD-Schmerzen), Martin Domin, M. Lotze).
Motorisch-Parietale Interaktion bei mentaler Rotation (Dr. Julia Berneiser; Doktorand Maximilian Kohler)
Beobachtete Schmerzen und Empathie nach Inselläsion (Alexander Lischke)


Literatur:
Strauss S., Barby S., Härtner J., Pfannmöller J., Neumann N., Moseley G.L., Lotze M. (2021) Graded motor imagery modifies movement pain, cortical excitability and sensorimotor function in CRPS. Brain Communications, accepted.
Strauss S., Barby S., Härtner J., Neumann N., Moseley G.L., Lotze M. (2021) Modifications in fMRI representation of mental rotation following a 6 week graded motor imagery training in chronic CRPS patients. Journal of Pain, accepted.
Kohler M., Strauss S., Horn U., Langner I., Usichenko T., Neumann N., Lotze M. (2019) Differences in neuronal representation of mental rotation in CRPS patients and healthy controls. The Journal of Pain, 20:898-907.
Review in Brain and Cognition: Resting-State Biomarkers for Chronic Pain - A Network View (2018); Authors: Jörg Pfannmöller and Martin Lotze
Usichenko T., Hacker H., Lotze M. (2017) Transcutaneous auricular vagal nerve stimulation (taVNS) might be a mechanism behind the analgesic effects of auricular acupuncture. Brain Stimulation, 10(6):1042-1044.
Strauß S, Grothe M, Usichenko T, Neumann N, Byblow WD, Lotze M. (2015) Inhibition of the primary sensorimotor cortex by topical anesthesia of the forearm in patients with CRPS. Pain, 156(12):2556-61.
Lotze M. and Moseley GL. (2015) Theoretical considerations for chronic pain rehabilitation. Physical Therapy, in press.
Usichenko T.I., Wesolowski T., Lotze M. (2015) Verum and sham acupuncture exert distinct cerebral activation in pain processing areas: a crossover fMRI investigation in healthy volunteers, Brain Imaging and Behavior, 9(2):236-44.
Lotze, M and Di Pietro F (2014) Brain activity and reorganization in CRPS. In: The Brain Adapting with Pain: Contribution of Neuroimaging Technology to pain mechanisms. Ed: Vania Apkarian. IASP Press, in press.
DiPietro F, Stanton TR, Moseley GL, Lotze M, Mc Aulley JH (2014) Interhemispheric somatosensory differences in chronic pain reflect abnormality of the healthy side. Human Brain Mapping, in press.
Di Pietro F., Stanton, TR., Parkitny L., McAuley JH., Lotze M., Wand BW, Moseley GL (2013) Primary somatosensory cortex function in complex regional pain syndrome: a systematic review & meta-analysis. Journal of Pain, in press.
Di Pietro F., McAuley JH. Parkitny L., Lotze M., Wand BW, Moseley GL Stanton, TR., (2013) Primary motor cortex function in complex regional pain syndrome: a systematic review & meta-analysis. Journal of Pain, in press.
Walz AD., Usichenko T., Moseley GL., Lotze M. (2012) Graded motor imagery and the impact on pain processing in a case of CRPS. Journal of Clinical Pain, in press.
Friebel, U., Eickhoff, S., Lotze M. (2011) Coordinate-based meta-analysis of experi-mentally induced and chronic persistent neuropathic pain, Neuroimage, 58(4):1070-80.
Gustin S.*, Schwarz A.*, Birbaumer N., Sines N., Veit R., Larbig W., Flor H., Lotze M (2010) NMDA-antagonist and morphine decrease CRPS-pain and cerebral pain-representation. Pain, 151: 69-76.
Wesolowski T., Lotze M., Domin M., Langner S., Lehmann C., Wendt M, Usichenko T (2009) Acupuncture reveals no specific effect on primary auditory cortex - an fMRI study. NeuroReport; 20(2):116-20.
Flor H., Nikolajsen L., Jensen T.S. Phantom limb pain: a case of maladaptive CNS plasticity? Nature Neuroscience Reviews (2006) 7: 873-881.
Lotze M., Flor H., Grodd W., Larbig W., Birbaumer N. Phantom movements and pain: an fMRI study in upper limb amputees. Brain (2001) 124: 2268-2277.
Lotze M., Grodd W., Birbaumer N., Erb M., Huse E., Flor H. Does the use of a myoelectric prosthesis prevent cortical reorganization and phantom limb pain? Nature Neuroscience (1999) 2: 501-502.


Die Arbeiten wurden 2000 und 2014 mit dem Deutschen Schmerzpreis und 2002 mit dem Förderpreis der Deutschen Gesellschaft für Neurotraumatologie und Klinische Neuropsychologie ausgezeichnet