Structural Brain Imaging in People With Low Back Pain

Abstract

Study Design cross-sectional study Objective The aim of this study was to determine whether low back pain (subacute and chronic) is related to differences in brain volume. Summary of Background Data Inconsistent findings have been reported about the effect of chronic low back pain on brain volume, and the effect of subacute low back pain on brain volume has not been sufficiently investigated. Methods 130 participants were included (23 subacute and 68 chronic low back pain; 39 healthy controls). The main outcome measure was whole and regional brain volume. Clinical outcome measures included pain duration, pain intensity, fear avoidance belief questionnaire, Oswestry disability index, and Beck’s depression inventory. Results Decrease in brain volume in several regions was observed in chronic low back pain when compared to health subjects; however after correcting for multiple comparisons, no significant differences were detected between any of the 3 groups in whole-brain volume. Regionally, we detected less gray matter volume in 2 voxels in the middle frontal gyrus in chronic low back pain participants compared to healthy controls. None of the clinical outcome measures were correlated with brain volume measurements. Conclusion Low back pain (subacute or chronic) is not related to significant differences in brain volume after correction for multiple comparisons. The effect size was too small to detect possible subtle changes unless much larger sample sizes are examined, or it is possible that low back pain does not affect brain volume.

What does the grey matter decrease in the medial prefrontal cortex reflect in people with chronic pain?

“…For example, there are mixed findings of the relationship between decreases in mPFC grey matter volume and affective disorders such as anxiety and depression in people with chronic pain. While some articles demonstrate a negative correlation between mPFC grey matter volume with anxiety and depression (Diaz‐Piedra, Guzman, Buela‐Casal & Catena, ; Seminowicz et al., ), others reveal no significant relationship (Abdallah & Geha, ; Ivo et al., ; Mansour et al., ; Robinson, Craggs, Price, Perlstein & Staud, ). The reason for this difference may be dependent on the major pathological pathway in our model, which may inevitably vary according to the type and/or severity of the chronic pain condition, and/or the type of the comorbid affective symptoms.…”

Relative contributions of the nervous system, spinal tissue and psychosocial health to non‐specific low back pain: Multivariate meta‐analysis

“…Reasons for exclusion at the fulltext stage are located in Table S9. Following full-text screening, 52 articles were eligible for synthesis (Apkarian et al, 2004;Barke et al, 2012;Boos et al, 1995;Buckalew et al, 2008;Burns, 2006;Carragee et al, 2000;D'Hooge et al, 2013;Derbyshire et al, 2002;Diers et al, 2007;Dolman et al, 2014;Dubois et al, 2016;Franz et al, 2014;Frymoyer et al, 1984Frymoyer et al, , 1985Gerhardt et al, 2016;Giesecke et al, 2004;Henchoz et al, 2013;Hubscher et al, 2014;Ivo et al, 2013;Jiang et al, 2016;Kim et al, 2019;Klyne et al, 2018;Kong et al, 2013;Kornelsen et al, 2013;Ladouceur et al, 2018;Letzen & Robinson, 2017;Lewis et al, 2010;Mansour et al, 2017;Mao et al, 2013;Marcuzzi et al, 2018;Meeus et al, 2010;Meier et al, 2016;Meints et al, 2019;Muhtz et al, 2013;Neziri et al, 2012;Nouwen et al, 2006;O'Neill et al, 2014;O'Sullivan et al, 2014;Owens et al, 2016;…”

“…Seminowicz et al, 2011;Tesarz et al, 2015;Ung et al, 2014;Vachon-Presseau et al, 2013;Vuilleumier et al, 2017;Wang et al, 2012;Wasan et al, 2011;Yang et al, 2017;Yu et al, 2014). Nineteen(Apkarian et al, 2004;Barke et al, 2012;Buckalew et al, 2008;Carragee et al, 2000;Frymoyer et al, 1984Frymoyer et al, , 1985Kong et al, 2013;Kornelsen et al, 2013;Mansour et al, 2017;Mao et al, 2013;Meier et al, 2016;Muhtz et al, 2013;O'Neill et al, 2014;Puta et al, 2012;Rodriguez-Raecke et al, 2014;Ung et al, 2014;Wang et al, 2012;Yang et al, 2017;Yu et al, 2014) could not be included in quantitative analyses as the required data were not presented and/or the authors did not respond despite a minimum of three contact attempts. Subsequently, 33 studies were available for quantitative synthesis(Boos et al, 1995;Burns, 2006;D'Hooge et al, 2013;Derbyshire et al, 2002;Diers et al, 2007;Dolman et al, 2014;Dubois et al, 2016;Franz et al, 2014;Gerhardt et al, 2016;Giesecke et al, 2004;…”

SVM Classification of Brain Gray Matter Volume Predicts Classic Trigeminal Neuralgia

“…Most chronic pain can affect the activity of these brain regions and even the structure of gray matter, and affect some advanced brain functions [30,31] .…”

“…The effects of pain on the cerebellum mainly include pain regulation, emotional processing, and sensorimotor processing [30,31] . In addition, the cerebellum can receive ber projections from the spinal cord and trigeminal nerve, and long-term intense pain stimulation can lead to structural changes in its local gray matter [33] .…”