Binlong Zhang1, Minyoung Jung1, Yiheng Tu1, Randy Gollub1, Courtney Lang1, Ana Ortiz1, Joel Park1, Georgia Wilson1, Jessica Gerber2, Ishtiaq Mawla2, Suk-Tak Chan2, Ajay Wasan3, Robert Edwards4, Jeungchan Lee2, Vitaly Napadow2, Ted Kaptchuk5, Bruce Rosen2, Jian Kong6. 1. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. 2. Department of Radiology, Martinos Center for Biomedical Imaging, Charlestown, MA, USA. 3. Department of Anesthesiology, Center for Pain Research, University of Pittsburgh, Pittsburgh, PA, USA. 4. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA. 5. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. 6. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Radiology, Martinos Center for Biomedical Imaging, Charlestown, MA, USA. Electronic address: jkong2@mgh.harvard.edu.
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.
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 cLBPpatients from healthy controls (HCs) and (2) identify brain regions that are sensitive to cLBPpain 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 cLBPpatients 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 cLBPpatients. PCL/SMA ALFF reliably discriminated cLBPpatients from HCs in an independent cohort. cLBPpatients 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.
Authors: Bruce Fischl; André van der Kouwe; Christophe Destrieux; Eric Halgren; Florent Ségonne; David H Salat; Evelina Busa; Larry J Seidman; Jill Goldstein; David Kennedy; Verne Caviness; Nikos Makris; Bruce Rosen; Anders M Dale Journal: Cereb Cortex Date: 2004-01 Impact factor: 5.357
Authors: Michael D Fox; Maurizio Corbetta; Abraham Z Snyder; Justin L Vincent; Marcus E Raichle Journal: Proc Natl Acad Sci U S A Date: 2006-06-20 Impact factor: 11.205
Authors: Daniel C Cherkin; Karen J Sherman; Andrew L Avins; Janet H Erro; Laura Ichikawa; William E Barlow; Kristin Delaney; Rene Hawkes; Luisa Hamilton; Alice Pressman; Partap S Khalsa; Richard A Deyo Journal: Arch Intern Med Date: 2009-05-11
Authors: Siyi Yu; Wen Li; Wei Shen; Robert R Edwards; Randy L Gollub; Georgia Wilson; Joel Park; Ana Ortiz; Jin Cao; Jessica Gerber; Ishtiaq Mawla; Suk-Tak Chan; Jeungchan Lee; Ajay D Wasan; Vitaly Napadow; Ted J Kaptchuk; Bruce Rosen; Jian Kong Journal: Neuroimage Date: 2020-05-18 Impact factor: 6.556
Authors: Divya Bharatkumar Adhia; Ramakrishnan Mani; John N J Reynolds; Sven Vanneste; Dirk De Ridder Journal: BMJ Open Date: 2022-06-15 Impact factor: 3.006
Authors: Yiheng Tu; Ana Ortiz; Randy L Gollub; Jin Cao; Jessica Gerber; Courtney Lang; Joel Park; Georgia Wilson; Wei Shen; Suk-Tak Chan; Ajay D Wasan; Robert R Edwards; Vitaly Napadow; Ted J Kaptchuk; Bruce Rosen; Jian Kong Journal: Neuroimage Clin Date: 2019-05-28 Impact factor: 4.881