Local abnormal white matter microstructure in the spinothalamic tract in people with chronic neck and shoulder pain.

Objective: To investigate differences in the microstructure of the spinothalamic tract (STT) white matter in people with chronic neck and shoulder pain (CNSP) using diffusion tensor imaging, and to assess its correlation with pain intensity and duration of the pain. Materials and methods: A 3.0T MRI scanner was used to perform diffusion tensor imaging scans on 31 people with CNSP and 24 healthy controls (HCs), employing the Automatic Fiber Segmentation and Quantification (AFQ) method to extract the STT and quantitatively analyze the fractional anisotropy (FA) and mean diffusivity (MD), reflecting the microstructural integrity of nerve fibers. Correlations of these differences with duration of pain and visual analog scale (VAS) scores were analyzed. Results: No significant differences in the mean FA or MD values of the bilateral STT were observed between people with CNSP and HCs ( Conclusion: This study found that people with CNSP exhibit white matter microstructural abnormalities in the specific segments of STT. These abnormalities are associated with the patient's pain intensity and disease duration. The findings offer a new neuroimaging perspective on the pathophysiological basis of chronic pain in the ascending conduction process and its potential role in developing targeted intervention strategies. However, due to the limited sample size and the lack of statistical significance when analyzing the entire spinothalamic tract, these conclusions should be interpreted with caution. Further research with larger cohorts is necessary to validate these results.