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IntroductionLumbar disc herniation, a chronic degenerative disease, is one of the major contributors to chronic low back pain and disability. Although many studies have been conducted in the past on brain function in chronic low back pain, most of these studies did not classify chronic low back pain (cLBP) patients according to their etiology. The lack of etiologic classification may lead to inconsistencies between findings, and the correlation between differences in brain activation and clinical symptoms in patients with cLBP was less studied in the past.MethodsIn this study, 36 lumbar disc herniation patients with chronic low back pain (LDHCP) and 36 healthy controls (HCs) were included to study brain activity abnormalities in LDHCP. Visual analogue scale (VAS), oswestry disability index (ODI), self-rating anxiety scale (SAS), self-rating depression scale (SDS) were used to assess clinical symptoms.ResultsThe results showed that LDHCP patients exhibited abnormally increased and diminished activation of brain regions compared to HCs. Correlation analysis showed that the amplitude of low frequency fluctuations (ALFF) in the left middle frontal gyrus is negatively correlated with SAS and VAS, while the right superior temporal gyrus is positively correlated with SAS and VAS, the dorsolateral left superior frontal gyrus and the right middle frontal gyrus are negatively correlated with VAS and SAS, respectively.ConclusionLDHCP patients have brain regions with abnormally increased and abnormally decreased activation compared to healthy controls. Furthermore, some of the abnormally activated brain regions were correlated with clinical pain or emotional symptoms.

BackgroundWith the change of life and work style, more middle-aged and elderly individuals are suffering from neck pain. In China, traditional Chinese exercises (TCEs) are widely used in the management of neck pain, such as Tai Chi, Qigong, Yijinjing, Baduanjin, Liuzijue, and Five-animal exercises. However, the evidence of TCEs for neck pain maintains controversial. Therefore, the current systematic review was conducted to evaluate the effects of TCEs on pain and disability of middle-aged and elderly patients with neck pain.MethodsA comprehensive literature search was performed in six electronic databases from their inception to January 2022 for randomized controlled trials of TCEs for neck pain. The methodological quality of the included studies was assessed by PEDro scale. The subgroup analysis was conducted based on different TCEs. The I2 statistic was applied to assess the heterogeneity.ResultsTwenty-one studies were included in our review, which were conducted in China, United States, and Germany between 2003 and 2021. Most (86%) of them exceeded the cut off score 6. TCEs included Baduanjin, Yijinjing, Tai Chi, Qigong, and Five-animal exercises. The aggregated results indicated that TCEs showed positive complementary effects in relieving pain (SMD, 1.12; 95% CI, 0.78–1.45; p < 0.00001), especially Baduanjin exercises. Baduanjin exercises also showed beneficial complementary effects in improving flexion (SMD, 0.65; 95% CI, 0.28–1.03; p = 0.0006) and extension (SMD, 0.66; 95% CI, 0.12–1.19; p = 0.02) of the neck. In addition, the aggregated results indicated that TCEs alone showed beneficial effects in improving disability (SMD, 0.74; 95% CI, 0.40–1.08; p < 0.0001) and relieving pain (SMD, 0.81; 95% CI, 0.50–1.13; p < 0.00001) compared with waiting list. The follow-up effects of TCEs were still insufficient.ConclusionThere was the positive evidence to support the clinical use of TCEs, as a complementary therapy, for middle-aged and elderly patients with neck pain, especially Baduanjin exercises. However, the evidence supporting the effects of TCEs alone for the middle-aged and elderly patients with neck pain was limited due to the small sample size.Systematic Review Registrationhttps://inplasy.com/inplasy-2022-4-0083/, identifier INPLASY202240083.