Evaluation of the pain matrix using EEG source localization: a feasibility study.

OBJECTIVES An extensive neuroimaging literature on chronic pain demonstrates increased cerebral blood flow and metabolism consistent with increased neuronal activity in the structures comprising the "pain matrix"; furthermore, some of these regions have been shown to encode pain intensity. It is the objective of this study to demonstrate the feasibility of using quantitative electroencephalography (EEG) source localization to reflect and to quantify activity in the pain matrix. METHODS Eyes closed resting EEG was recorded from 19 standardized scalp locations, in a pilot sample of five patients with chronic neuropathic pain, before and after pain reduction. Quantitative electro encephalography (QEEG) source localization was computed estimating the mathematically most probable source generators of EEG surface potentials in each state. Sources identified in this way have been demonstrated to coregister with those identified by neuroimaging methods. RESULTS QEEG sources demonstrated frequency specific increased neuronal activity in the baseline high pain state in structures including the thalamus, somatosensory cortex, anterior and posterior insula, medial and lateral prefrontal cortex and cingulate. Significant reduction of activation in these regions was seen when pain was reduced (≥50% on subjective ratings). CONCLUSION The areas that were activated in the high pain state localized to the same regions reported by other neuroimaging methods and with frequency specificity. The frequency and regionally specific activation may indicate distinctive patterns of pathophysiology underlying the pain matrix. Although in a small number of patients, this work suggests that QEEG may be a useful tool in the exploration and quantification of the pain matrix in a clinical setting.