Abnormal brain activity in lumbar disc herniation patients with chronic pain is associated with their clinical symptoms

Abstract

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.

Degree centrality-based resting-state functional magnetic resonance imaging explores central mechanisms in lumbar disc herniation patients with chronic low back pain

“…This region collaborates with other brain regions to form a complex neural network that is foundational to higher cognitive functions in humans. Studies have shown that temporal lobe involvement is associated with unpleasant emotions (41)(42)(43) and that the temporal lobe is primarily responsible for pain perception and emotional processing (5,44,45). Presently, researchers are observing structural and functional changes in this region in a variety of pain-related disorders (46)(47)(48)(49)(50)(51)(52).…”

“…(3) no history of CLBP or other chronic pain conditions; (4) general health with no history of chronic systemic diseases, such as diabetes mellitus or hypertension; (5) no psychiatric or neurological disorders; and (6) absence of abnormal findings, such as infarcts or focal lesions, on brain MRI manifestations, as confirmed by two uninformed independent radiologists.…”

“…Lumbar disc herniation (LDH) occurs due to a rupture of the annulus fibrosus of the intervertebral disc, leading to protrusion or prolapse of the nucleus pulposus into the posterior spinal canal. This results in irritation or compression of the corresponding nerve roots, manifesting as a series of clinical symptoms including CLBP ( 4 , 5 ). LDH is one of the main causes of CLBP, resulting in physical inactivity, increased psychological distress, diminished social functional capacity, and a significant reduction in quality of life ( 6 ).…”

Research on the multidimensional brain remodeling mechanisms at the level of brain regions, circuits, and networks in patients with chronic lower back pain caused by lumbar disk herniation

“…Resting-state functional magnetic resonance imaging (rs-fMRI) is a non-invasive brain functional detection technique that provides important information for understanding disease mechanisms and guiding clinical practice. This technique has garnered significant attention from clinicians and researchers due to its numerous advantages, including non-ionizing radiation, high image clarity, ease of localization, and repeatability ( Yu et al, 2014 ; Letzen and Robinson, 2017 ; Yang et al, 2017 ; Goossens et al, 2018 ; Li et al, 2018 ; Huang et al, 2019 ; Yu et al, 2021 ; Tang et al, 2023 ), and it does not require subjects to perform specific tasks. The brains of chronic pain patients need to continuously process spontaneous pain, which might interfere with other conscious and unconscious processes ( Borsook et al, 2018 ).…”