Preprint Evidence for a role of skull bone marrow in human chronic pain as revealed by TSPO PET imaging, 2025, Mohammadian et al.

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Evidence for a role of skull bone marrow in human chronic pain as revealed by TSPO PET imaging
Mehrbod Mohammadian; Nikos Efthimou; Ludovica Brusaferri; Joya Cooper-Hohn; Minhae Kim; Jennifer P. Murphy; Zeynab Alshelh; Grace Grmek; Jack H. Schnieders; Courtney A. Chane; Thomas G. Carmichael; Danika Yang; Ciprian Catana; Steven M. Stufflebeam; Robert R. Edwards; Vitaly Napadow; Kimberly Sullivan; Matthias Nahrendorf; Jodi M. Gilman; Marco L. Loggia

The skull bone marrow is emerging as a critical hub for neuroimmune signaling in various disorders, with the potential to reshape how we understand brain-immune interactions. However, its role in chronic pain is unknown.

Using integrated positron emission tomography / magnetic resonance imaging, here we show that the levels of 18 kDa translocator (TSPO), a marker of immune cell density, is elevated in the skull bone marrow of patients with chronic pain (N=125; chronic low back pain [cLBP], N=88; knee osteoarthritis [KOA], N=37), compared to healthy controls (N=22). These elevations were very widespread, generally more pronounced for KOA than cLBP, and associated with greater pain intensity, pain interference, depression, and anxiety (all p < 0.001).

Because TSPO is highly expressed in myeloid cells, these results associate skull bone marrow immune dysregulation with chronic pain and its associated psychological and functional impairments. These findings provide a strong rationale for investigating this previously overlooked structure, which remains largely underexplored in the context of pain.

Web | PDF | Preprint: MedRxiv | Open Access
 
So they’ve gone fishing for a correlation between a measurement and pain, and based on finding one, they conclude that it’s evidence for it playing a role in pain?
 
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