Neural activity during cognitive reappraisal in chronic low back pain: a preliminary study

Abstract Objectives Chronic pain patients often report higher levels of negative emotions, suggesting reduced ability to regulate emotions effectively, however, little is known of the underlying neural cognitive mechanisms. Therefore, the aim of this study was to explore brain activity and connectivity during cognitive reappraisal in chronic low back pain (CLBP). Methods This study recruited 24 female participants; 12 with CLBP and 12 healthy controls. Participants completed an emotion regulation task that involved cognitive reappraisal of negative images during functional magnetic resonance imaging. The negative affect following each image and perceived success of the task were reported. Region of interest and seed-to-voxel analyses were conducted using key regions involved in cognitive reappraisal (i.e., amygdalae and dorsomedial prefrontal cortex) as seed regions. Results During the task, there were no group differences in the behavioural measures and blood oxygen level-dependent (BOLD) brain activation in the seed regions. Functional connectivity analysis showed reduced coupling between the amygdalae and dorsolateral prefrontal cortex, orbitofrontal cortex and inferior parietal cortex in the CLBP group compared to controls. Connectivity between the amygdala and inferior parietal cortex positively correlated with the percent of reduced negative affect during reappraisal in the CLBP group. Conclusions These preliminary findings demonstrate that individuals with CLBP exhibit similar emotion regulation abilities to healthy controls at the behavioural and BOLD level. However, altered functional connectivity observed in the CLBP group may reduce effective cognitive reappraisal. These results provide evidence for the potential clinical impact of network changes in CLBP.

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Abnormal medial prefrontal cortex functional connectivity and its association with clinical symptoms in chronic low back pain

Pain ◽

10.1097/j.pain.0000000000001747 ◽

2020 ◽

Vol 161 (1) ◽

pp. 230-231

Keyword(s):

Low Back Pain ◽

Prefrontal Cortex ◽

Back Pain ◽

Functional Connectivity ◽

Medial Prefrontal Cortex ◽

Chronic Low Back Pain ◽

Clinical Symptoms ◽

Low Back

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

Acupuncture in Medicine ◽

10.1136/acupmed-2013-010423 ◽

2014 ◽

Vol 32 (2) ◽

pp. 102-108 ◽

Cited By ~ 33

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.

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Examining resting-state functional connectivity in key hubs of the default mode network in chronic low back pain

Scandinavian Journal of Pain ◽

10.1515/sjpain-2020-0184 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Sin Ki Ng ◽

Donna M. Urquhart ◽

Paul B. Fitzgerald ◽

Flavia M. Cicuttini ◽

Melissa Kirkovski ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Functional Connectivity ◽

Default Mode Network ◽

Chronic Low Back Pain ◽

Resting State ◽

Angular Gyrus ◽

Healthy Controls ◽

Low Back ◽

Default Mode

Abstract Objectives Changes in brain connectivity have been observed within the default mode network (DMN) in chronic low back pain (CLBP), however the extent of these disruptions and how they may be related to CLBP requires further examination. While studies using seed-based analysis have found disrupted functional connectivity in the medial prefrontal cortex (mPFC), a major hub of the DMN, limited studies have investigated other equally important hubs, such as the posterior cingulate cortex (PCC) in CLBP. Methods This preliminary study comprised 12 individuals with CLBP and 12 healthy controls who completed a resting-state functional magnetic resonance imaging (fMRI) scan. The mPFC and PCC were used as seeds to assess functional connectivity. Results Both groups displayed similar patterns of DMN connectivity, however group comparisons showed that CLBP group had reduced connectivity between the PCC and angular gyrus compared to healthy controls. An exploratory analysis examined whether the alterations observed in mPFC and PCC connectivity were related to pain catastrophizing in CLBP, but no significant associations were observed. Conclusions These results may suggest alterations in the PCC are apparent in CLBP, however, the impact and functional role of these disruptions require further investigation.

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Abnormal medial prefrontal cortex functional connectivity and its association with clinical symptoms in chronic low back pain

Pain ◽

10.1097/j.pain.0000000000001507 ◽

2019 ◽

Vol 160 (6) ◽

pp. 1308-1318 ◽

Cited By ~ 17

Author(s):

Yiheng Tu ◽

Minyoung Jung ◽

Randy L. Gollub ◽

Vitaly Napadow ◽

Jessica Gerber ◽

...

Keyword(s):

Low Back Pain ◽

Prefrontal Cortex ◽

Back Pain ◽

Functional Connectivity ◽

Medial Prefrontal Cortex ◽

Chronic Low Back Pain ◽

Clinical Symptoms ◽

Low Back

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Immediate effects of myofascial release on neuromechanical characteristics in female and male patients with low back pain and healthy controls as assessed by tensiomyography. A controlled matched-pair study

Clinical Biomechanics ◽

10.1016/j.clinbiomech.2021.105351 ◽

2021 ◽

pp. 105351

Author(s):

Christine Lohr ◽

Ivan Medina-Porqueres

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Matched Pair ◽

Healthy Controls ◽

Low Back ◽

Myofascial Release ◽

Male Patients

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Sensorimotor and body perception assessments of nonspecific chronic low back pain: a cross-sectional study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04269-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

R. Meier ◽

C. Emch ◽

C. Gross-Wolf ◽

F. Pfeiffer ◽

A. Meichtry ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Cross Sectional Study ◽

Sensorimotor System ◽

Healthy Controls ◽

Low Back ◽

Sectional Study ◽

Clinical Tests ◽

Body Perception ◽

Cross Sectional

Abstract Background Low back pain (LBP) is one of the most common musculoskeletal disorders, causing significant personal and social burden. Current research is focused on the processes of the central nervous system (particularly the sensorimotor system) and body perception, with a view to developing new and more efficient ways to treat chronic low back pain (CLBP). Several clinical tests have been suggested that might have the ability to detect alterations in the sensorimotor system. These include back-photo assessment (BPA), two-point discrimination (TPD), and the movement control tests (MCT). The aim of this study was to determine whether the simple clinical tests of BPA, TPD or MCT are able to discriminate between nonspecific CLBP subjects with altered body perception and healthy controls. Methods A cross-sectional study was conducted. At one point in time, 30 subjects with CLBP and 30 healthy controls were investigated through using BPA, TPD and MCT on the lower back. Correlations among the main covariates and odds ratios for group differences were calculated. Results MCT showed an odds ratio for the presence of CLBP of 1.92, with a statistically significant p-value (0.049) and 95%CI. The TPD and BPA tests were unable to determine significant differences between the groups. Conclusions Of the three tests investigated, MCT was found to be the only suitable assessment to discriminate between nonspecific CLBP subjects and healthy controls. The MCT can be recommended as a simple clinical tool to detect alterations in the sensorimotor system of nonspecific CLBP subjects. This could facilitate the development of tailored management strategies for this challenging LBP subgroup. However, further research is necessary to elucidate the potential of all the tests to detect alterations in the sensorimotor system of CLBP subjects. Trial registration No trial registration was needed as the study contains no intervention. The study was approved by the Swiss Ethics Commission of Northwest and Central Switzerland (EKNZ) reference number 2015–243.

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POS1290 CYTOKINE BIOMARKERS IN COMMON LOW BACK PAIN

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4205 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 926.3-926

Author(s):

R. Dhahri ◽

A. Dghaies ◽

M. Slouma ◽

L. Metoui ◽

I. Gharsallah ◽

...

Keyword(s):

Neuropathic Pain ◽

Low Back Pain ◽

Back Pain ◽

Inflammatory Cytokines ◽

Enzyme Linked Immunosorbent Assay ◽

Healthy Controls ◽

Low Back ◽

Tnf Α ◽

Functional Scores ◽

The Mean

Background:Common low back pain (LBP) is a common health problem affecting 50 to 80% of working age adults. It is one of the common and costly health problems in Tunisia. Actually, the role of the immune response and inflammatory cytokines in the pathogenesis of chronic pain has been of growing interest.Objectives:The aim of this study was to assess whether pro and anti-inflammatory cytokines could be detected in serum in patients with LBP compared with healthy subjects and whether they could be related to pain severity and to clinical findings.Methods:It was a an analytical cross-sectional study including 50 patients with at least three months of LBP, in the department of rheumatology, orthopedics and immunology at the Military Hospital of Tunis between January 1st and March 31, 2020. All patients had a standardized clinical assessment.Levels of serum cytokines IL-6, IL-8, IL-1β and TNF- α, were measured using the chimiluminescence technique. Serum concentration of IL-10 was assayed by the enzyme-linked immunosorbent assay technique (ELISA). The normal levels of cytokines were determined in 50 healthy controls.Results:The mean age of the patients was 41.9 ± 8.4 years and the sex ratio was 4.5. LBP duration was 66.4 months. The mean lumbar visual analog scale (VAS) was 4.5 ± 1.9, and the root VAS was 2.6 ± 2.5. Neuropathic pain was found in 26% of patients. The average BMI was 27 ± 3.7 kg/m2. Only serum level of IL-8 was significantly higher in subjects with LBP compared to healthy controls (p <10-3). IL-1β was indetectable in both patients and controls. Positive correlations were found between IL-8 levels and anxiety/functional scores (r = 0.3; p = 0.02/ r = 0.3; p = 0.04). IL-6 was positively correlated with BMI, and negatively correlated with the Schober test. No correlations were found between serum levels of IL-6, IL-8, IL-10, TNF-α and pain intensity (VAS), neuropathic pain (DN4), fibromyalgia (FIRST), depression (HAD) and various radiological data.Conclusion:Interleukin-8 is a biomarker of common low back pain and correlate with anxiety and functional disability. These results suggest that IL-8 may be a therapeutic target to reduce chronic back pain and reduce the social and profession impact.Disclosure of Interests:None declared

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Rasterstereographic Analysis of Lateral Shift in Patients with Lumbar Disc Herniation: A Case Control Study

Advances in Orthopedics ◽

10.1155/2018/6567139 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8

Author(s):

Britta K. Krautwurst ◽

Jürgen R. Paletta ◽

Sylvia Mendoza ◽

Adrian Skwara ◽

Melvin Mohokum

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Pelvic Tilt ◽

Lumbar Disc ◽

Lateral Shift ◽

Healthy Controls ◽

Low Back

Objective. Detection of a lateral shift (LS) in patients with diagnosed disc herniation compared to healthy controls. Summary of Background Data. A specific lateral shift (LS) pattern is observed in patients with disc herniation and low back pain, as shown in earlier studies. Methods. Rasterstereography (RS) was used to investigate the LS. Thirty-nine patients with lumbar disc herniation diagnosed by radiological assessment and low back pain and/or leg pain (mean age 48.2 years, mean BMI 28.5, 28 males and 11 females) and 36 healthy controls (mean age 47.4 years, mean BMI 25.7, 25 males and 11 females) were analysed. LS, pelvic tilt, pelvic inclination, lordotic angle, and trunk torsion were assessed. Results. The patient group showed a nonsignificant increase in LS, that is, 5.6 mm compared to the healthy controls with 5.0 mm (p = 0.693). However, significant differences were found between groups regarding pelvic tilt in degrees (patients 5.9°, healthy controls 2.0°; p = 0.016), trunk torsion (patients 7.5°, controls 4.5°; p = 0.017), and lordotic angle (patients 27.5°, healthy controls 32.7°; p = 0.022). The correlation between pain intensity and the FFbH-R amounted 0.804 (p = < 0.01), and that between pain intensity and the pain disability index was 0.785 (p < 0.01). Discussion. Although some studies have illustrated LS with disc herniation and low back pain, the present findings demonstrate no significant increase in LS in the patient group compared to healthy controls. Conclusion. The patients with lumbar disc herniation did not demonstrate an increased LS compared to healthy controls. Other parameters like pelvic tilt and inclination seemed to be more suitable to identify changes in posture measured by RS in patients with low back pain or disc herniation.

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