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Identifying brain regions associated with the neuropathology of chronic low back pain: a resting-state amplitude of low-frequency fluctuation study

Authors :
Binlong Zhang
Georgia Wilson
Suk-Tak Chan
Bruce R. Rosen
Jessica Gerber
Jian Kong
Yiheng Tu
Minyoung Jung
Vitaly Napadow
Ted J. Kaptchuk
Robert R. Edwards
Ana Ortiz
Ajay D. Wasan
Randy L. Gollub
Joel Park
Jeungchan Lee
Courtney Lang
Ishtiaq Mawla
Source :
British Journal of Anaesthesia. 123:e303-e311
Publication Year :
2019
Publisher :
Elsevier BV, 2019.

Abstract

Background Previous studies have found widespread pain processing alterations in the brain in chronic low back pain (cLBP) patients. We aimed to (1) identify brain regions showing altered amplitude of low-frequency fluctuations (ALFF) using MRI and use these regions to discriminate cLBP patients from healthy controls (HCs) and (2) identify brain regions that are sensitive to cLBP pain intensity changes. Methods We compared ALFF differences by MRI between cLBP subjects (90) and HCs (74), conducted a discriminative analysis to validate the results, and explored structural changes in key brain regions of cLBP. We also compared ALFF changes in cLBP patients after pain-exacerbating manoeuvres. Results ALFF was increased in the post-/precentral gyrus (PoG/PrG), paracentral lobule (PCL)/supplementary motor area (SMA), and anterior cingulate cortex (ACC), and grey matter volume was increased in the left ACC in cLBP patients. PCL/SMA ALFF reliably discriminated cLBP patients from HCs in an independent cohort. cLBP patients showed increased ALFF in the insula, amygdala, hippocampal/parahippocampal gyrus, and thalamus and decreased ALFF in the default mode network (DMN) when their spontaneous low back pain intensity increased after the pain-exacerbating manoeuvre. Conclusions Brain low-frequency oscillations in the PCL, SMA, PoG, PrG, and ACC may be associated with the neuropathology of cLBP. Low-frequency oscillations in the insula, amygdala, hippocampal/parahippocampal gyrus, thalamus, and DMN are sensitive to manoeuvre-induced spontaneous back pain intensity changes.

Details

ISSN :
00070912
Volume :
123
Database :
OpenAIRE
Journal :
British Journal of Anaesthesia
Accession number :
edsair.doi.dedup.....e4544e3d0512b29baf2956b6ef75b926
Full Text :
https://doi.org/10.1016/j.bja.2019.02.021