scholarly journals Enhanced Temporal Coupling between Thalamus and Dorsolateral Prefrontal Cortex Mediates Chronic Low Back Pain and Depression

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Hong Li ◽  
Qiaoyan Song ◽  
Ruya Zhang ◽  
Youlong Zhou ◽  
Yazhuo Kong
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Prefrontal Cortex ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Dorsolateral Prefrontal Cortex ◽  
Brain Plasticity ◽  
Low Back ◽  
Dorsolateral Prefrontal ◽  
Temporal Coupling

Numerous neuroimaging studies have demonstrated that the brain plasticity is associated with chronic low back pain (cLBP). However, there is a lack of knowledge regarding the underlying mechanisms of thalamic pathways for chronic pain and psychological effects in cLBP caused by lumbar disc herniation (LDH). Combining psychophysics and magnetic resonance imaging (MRI), we investigated the structural and functional brain plasticity in 36 patients with LDH compared with 38 age- and gender-matched healthy controls. We found that (1) LDH patients had increased psychophysical disturbs (i.e., depression and anxiety), and depression (Beck-Depression Inventory, BDI) was found to be an outstanding significant factor to predict chronic pain (short form of the McGill Pain Questionnaire, SF-MPQ); (2) the LDH group showed significantly smaller fractional anisotropy values in the region of posterior corona radiate while gray matter volumes were comparable in both groups; (3) resting state functional connectivity analysis revealed that LDH patients exhibited increased temporal coupling between the thalamus and dorsolateral prefrontal cortex (DLPFC), which further mediate the relationship from chronic pain to depression. Our results emphasized that thalamic pathways underlying prefrontal cortex might play a key role in regulating chronic pain and depression of the pathophysiology of LDH.

scholarly journals An Observational Study Comparing Fibromyalgia and Chronic Low Back Pain in Somatosensory Sensitivity, Motor Function and Balance

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1533
Author(s):  
José Antonio Mingorance ◽  
Pedro Montoya ◽  
José García Vivas Miranda ◽  
Inmaculada Riquelme
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Observational Study ◽  
Motor Function ◽  
Chronic Low Back Pain ◽  
Functional Performance ◽  
Low Back ◽  
Somatosensory Sensitivity ◽  
Chronic Pain Conditions

Fibromyalgia (FM) and chronic low back pain (CLBP) have shared pathophysiology and have a considerable impact on patients’ daily activities and quality of life. The main objective of this study was to compare pain impact, somatosensory sensitivity, motor functionality, and balance among 60 patients with FM, 60 patients with CLBP, and 60 pain-free controls aged between 30 and 65 years. It is essential to know the possible differences existing in symptomatology of two of the major chronic pain processes that most affect the population, such as FM and CLBP. The fact of establishing possible differences in sensory thresholds, motor function, and proprioceptive measures among patients with FM and CLBP could bring us closer to a greater knowledge of the chronic pain process. Through an observational study, a comparison was made between the three groups (FM, CLBP, and pain-free controls) evaluating functional performance, postural balance, kinematic gait parameters, strength, depression, fatigue, and sensitivity to pain and vibration. Patients with chronic pain showed worse somatosensory sensitivity (p < 0.001) and motor function (p < 0.001) than pain-free controls. Moreover, patients with FM showed greater pain impact (p < 0.001) and bigger somatosensory (p < 0.001) and motor deficiencies (p < 0.001) than patients with CLBP. Further research should explore the possible reasons for the greater deterioration in patients with FM in comparison with other chronic pain conditions. Our results, showing the multiple areas susceptible of deterioration, make it necessary to adopt interdisciplinary interventions focused both on physical and emotional dysfunction.

scholarly journals Effect of the duration of chronic low back pain on pain sensitivity of patients undergoing lumbar fusion surgery

Pain medicine ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 8-15
Author(s):  
Mei-ping Qian ◽  
Mei-rong Dong ◽  
Fang Kang ◽  
Juan Li
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Hospital Stay ◽  
Chronic Low Back Pain ◽  
Pain Sensitivity ◽  
Lumbar Fusion ◽  
Low Back ◽  
Fusion Surgery ◽  
Lumbar Fusion Surgery

Background: chronic low back pain is a serious social problem. In recent years, patients who choose lumbar fusion surgery due to chronic low back pain has been increasing. Pre-existing chronic pain has been associated with severe postoperative pain. In this study, we have sought to prospectively analyze the association between the duration of chronic low back pain and pain sensitivity after lumbar fusion surgery. Methods: 400 patients who underwent lumbar fusion surgery were divided into three groups based on the duration of chronic pain. During the first postoperative day, the maximum pain scores of each patient day and night, the pain scores at the day of discharge, the consumption of postoperative analgesics and the length of hospital stay were recorded. Results: of 400 patients recruited, 369 patients completed the experiment. There was no significant difference in gender, age, height, weight, pre-operative pain at rest, and operation time in the three groups. During the day, the pain sensitivity of the three groups were 1.71 ± 0.66, 2.40 ± 0.74, 2.90 ± 0.80. During the night, the pain sensitivity of the three groups were 3.45 ± 0.81, 4.31 ± 1.06, 4.86 ± 1.05. At the day of discharge, the pain sensitivity of three groups were 1.26 ± 0.46, 1.47 ± 0.58, 1.96 ± 0.64. There were significant differences in pain sensitivity among the three groups during the day and night on the first postoperative day and at the day of discharge (p < 0.05). The length of hospital stay (7.31 ± 1.36 days, 8.82 ± 1.48 days, 9.60 ± 1.61 days) and analgesic consumption (25.04 ± 36.56 mg, 33.52 ± 24.04 mg, 45.15 ± 24.89 mg, morphine equivalent) were also significant differences (p < 0.05). Conclusion: we found the duration of chronic low back pain before lumbar fusion surgery affects patient’ postoperative pain sensitivity, consumption of analgesic drugs and hospital stay. The longer the preoperative chronic pain lasts, the higher the postoperative VAS score is, the more analgesic drugs were consumed, and the longer hospital stay is.

scholarly journals Perceived Injustice Helps Explain the Association Between Chronic Pain Stigma and Movement-Evoked Pain in Adults with Nonspecific Chronic Low Back Pain

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 3161-3171
Author(s):  
Terence M Penn ◽  
Demario S Overstreet ◽  
Edwin N Aroke ◽  
Deanna D Rumble ◽  
Andrew M Sims ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Physical Function ◽  
Indirect Effect ◽  
Chronic Low Back Pain ◽  
Pain Severity ◽  
Low Back ◽  
Perceived Injustice ◽  
Objective Basis

Abstract Objective For most patients with chronic low back pain (cLBP), the cause is “nonspecific,” meaning there is no clear association between pain and identifiable pathology of the spine or associated tissues. Laypersons and providers alike are less inclined to help, feel less sympathy, dislike patients more, suspect deception, and attribute lower pain severity to patients whose pain does not have an objective basis in tissue pathology. Because of these stigmatizing responses from others, patients with cLBP may feel that their pain is particularly unjust and unfair. These pain-related injustice perceptions may subsequently contribute to greater cLBP severity. The purpose of this study was to examine whether perceived injustice helps explain the relationship between chronic pain stigma and movement-evoked pain severity among individuals with cLBP. Methods Participants included 105 patients with cLBP who completed questionnaires assessing chronic pain stigma and pain-related injustice perception, as well as a short physical performance battery for the assessment of movement-evoked pain and physical function. Results Findings revealed that perceived injustice significantly mediated the association between chronic pain stigma and cLBP severity (indirect effect = 6.64, 95% confidence interval [CI] = 2.041 to 14.913) and physical function (indirect effect = −0.401, 95% CI = −1.029 to −0.052). Greater chronic pain stigma was associated with greater perceived injustice (P = 0.001), which in turn was associated with greater movement-evoked pain severity (P = 0.003). Conclusions These results suggest that perceived injustice may be a means through which chronic pain stigma impacts nonspecific cLBP severity and physical function.

scholarly journals Influence of sleep problems and co-occurring musculoskeletal pain on long-term prognosis of chronic low back pain: the HUNT Study

2019 ◽  
Vol 74 (3) ◽  
pp. 283-289 ◽  
Author(s):  
Eivind Schjelderup Skarpsno ◽  
Paul Jarle Mork ◽  
Tom Ivar Lund Nilsen ◽  
Anne Lovise Nordstoga
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Musculoskeletal Pain ◽  
Chronic Low Back Pain ◽  
Sleep Problems ◽  
Low Back ◽  
Hunt Study ◽  
Long Term Prognosis

BackgroundWe investigated the influence of sleeplessness and number of insomnia symptoms on the probability of recovery from chronic low back pain (LBP), and the possible interplay between sleeplessness and co-occurring musculoskeletal pain on this association.MethodsThe study comprised data on 3712 women and 2488 men in the Norwegian HUNT study who reported chronic LBP at baseline in 1995–1997. A modified Poisson regression model was used to calculate adjusted risk ratios (RRs) for the probability of recovery from chronic LBP at follow-up in 2006–2008, associated with sleep problems and co-occurring musculoskeletal pain at baseline.ResultsCompared with persons without sleeplessness, persons who often/always experienced sleeplessness had a lower probability of recovery from chronic LBP (RR 0.65, 95% CI 0.57 to 0.74 in women and RR 0.81, 95% CI 0.69 to 0.95 in men). Although there was no clear evidence of statistical interaction between sleeplessness and co-occurring musculoskeletal pain, women and men who often/always experienced sleeplessness and had ≥5 additional chronic pain sites had RRs of recovery of 0.40 (95% CI 0.33 to 0.48) and 0.59 (95% CI 0.45 to 0.78), respectively, compared with persons without sleeplessness and 1–2 chronic pain sites.ConclusionThese findings suggest that preventing or reducing sleep problems among people with chronic LBP may have the potential of improving the long-term prognosis of this condition, also among those with several additional pain sites.

Chronic pain and depression. III. Family history study of depression and alcoholism in chronic low back pain patients

Pain ◽  
1986 ◽  
Vol 24 (2) ◽  
pp. 185-190 ◽  
Author(s):  
Randal D. France ◽  
Ranga K. Rama Krishnan ◽  
Mary Trainor
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Family History ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Pain Patients

Family History and Severity of Disability Associated with Chronic Low Back Pain

1985 ◽  
Vol 57 (3) ◽  
pp. 813-814 ◽  
Author(s):  
C. Alec Pollard
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Family History ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Pain Disability Index ◽  
Pain Disability ◽  
Severity Of Disability ◽  
Chronic Pain Conditions

76 patients with chronic low back pain were asked to complete the Pain Disability Index and a family history pain checklist. A significant positive relationship was found between severity of chronic pain disability and the number of chronic pain conditions in the patients' families of origin and genesis. These findings support the position that pain disability is learned from family members, but controlled research is needed before dismissing the possible role of genetic and other factors.

Chronic pain and depression. II. Symptoms of anxiety in chronic low back pain patients and their relationship to subtypes of depression

Pain ◽  
1985 ◽  
Vol 22 (3) ◽  
pp. 289-294 ◽  
Author(s):  
Ranga Rama K. Krishnan ◽  
Randal D. France ◽  
Susan Pelton ◽  
Una D. McCann ◽  
Jonathan Davidson ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Pain Patients

Acupuncture Treatment of Chronic Low Back Pain Reverses An Abnormal Brain Default Mode Network in Correlation with Clinical Pain Relief

2014 ◽  
Vol 32 (2) ◽  
pp. 102-108 ◽  
Author(s):  
Ji Li ◽  
Jun-Hai Zhang ◽  
Tao Yi ◽  
Wei-Jun Tang ◽  
Song-Wei Wang ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Prefrontal Cortex ◽  
Back Pain ◽  
Default Mode Network ◽  
Chronic Low Back Pain ◽  
Therapeutic Effects ◽  
Healthy Controls ◽  
Low Back ◽  
Default Mode ◽  
Clinical Pain

Background Acupuncture is gaining in popularity as a treatment for chronic low back pain (cLBP); however, its therapeutic mechanisms remain controversial, partly because of the absence of an objective way of measuring subjective pain. Resting-state functional MRI (rsfMRI) has demonstrated aberrant default mode network (DMN) connectivity in patients with chronic pain, and also shown that acupuncture increases DMN connectivity in pain-modulator and affective-emotional brain regions of healthy subjects. Objective This study sought to explore how cLBP influences the DMN and whether, and how, the altered DMN connectivity is reversed after acupuncture for clinical pain. Methods RsfMRI data from 20 patients with cLBP, before and after 4 weeks of treatment, and 10 age- and gender-matched healthy controls (without treatment) were analysed using independent components analyses to determine connectivity within the DMN, and combined with correlation analyses to compute covariance between changes in DMN connectivity and changes in clinical pain. Visual analogue scale data were assessed to rate clinical pain levels. Results Less connectivity within the DMN was found in patients with cLBP than in healthy controls, mainly in the dorsolateral prefrontal cortex, medial prefrontal cortex, anterior cingulate gyrus and precuneus. After acupuncture, patients’ connectivities were restored almost to the levels seen in healthy controls. Furthermore, reductions in clinical pain were correlated with increases in DMN connectivity. Conclusions This result suggests that modulation of the DMN by acupuncture is related to its therapeutic effects on cLBP. Imaging of the DMN provides an objective method for assessment of the effects of acupuncture-induced analgesia.

Biogenic, Psychogenic, and Sociogenic Models of Adjustment to Chronic Pain: An Exploratory Study

1993 ◽  
Vol 23 (1) ◽  
pp. 63-80 ◽  
Author(s):  
Mark Peyrot ◽  
Philip M. Moody ◽  
H. Jean Wiese
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Psychological Distress ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Exploratory Study ◽  
Somatic Complaints ◽  
Organic N ◽  
Low Back ◽  
Anxiety Depression

Objective: Based upon three models of etiology and adjustment in CLBP, predictions were made about the variables that were expected to differentiate organic and nonorganic patients, including: psychological distress (anxiety, depression, stress, alienation), pain condition and treatment, and general health. Method: Patients from a medical school orthopedic clinic with an organic ( N = 58) or a nonorganic ( N = 33) diagnosis for chronic low back pain (CLBP) were compared on medical, psychological and sociodemographic variables. Results: Nonorganic patients exhibited greater emotional distress, contrary to the biogenic model, and nonorganic patients did not exhibit more somatic complaints, contrary to the psychogenic model. Both patterns were consistent with the sociogenic model; nonorganic patients were more distressed, but not because of a greater tendency to somatize. Moreover, modeling was not supported as an explanation of the pain and distress among these patients. Conclusions: Social anomie may explain why patients without a medically diagnosable cause for their pain are more psychologically distressed.

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