Differences in brain structure and function in older adults with self-reported disabling and nondisabling chronic low...

Area of Science:

• Neuroscience
• Gerontology
• Pain Research

Background:

• Chronic low back pain (CLBP) is a prevalent condition in older adults, often leading to disability.
• Understanding the neurobiological underpinnings of CLBP-related disability is crucial for developing effective interventions.

Purpose of the Study:

• To investigate structural and functional brain differences in older adults with disabling versus nondisabling CLBP.
• To explore the relationship between brain morphology, pain duration, and physical function in this population.

Main Methods:

• A cross-sectional pilot study involving 16 cognitively intact older adults (8 with disabling CLBP, 8 with nondisabling CLBP).
• Participants underwent structural and functional brain MRI, neuropsychological testing, and physical performance assessments.
• Exclusion criteria included psychiatric/neurological disorders, substance abuse, opioid use, or diabetes.

Main Results:

• The disabling CLBP group exhibited significantly lower white matter (WM) integrity in the splenium of the corpus callosum.
• Functional MRI revealed distinct resting-state activation patterns: right medial prefrontal cortex in the disabled group and left lateral prefrontal cortex in the nondisabled group.
• A positive correlation was found between WM integrity of the left centrum semiovale and gait speed (r(s) = 0.80, P < 0.0002).
• Negative correlation between CLBP duration and WM integrity of the splenium of the corpus callosum (r(s) = -0.59, P < 0.02).

Conclusions:

• Significant differences in brain structure and function exist between older adults with disabling and nondisabling CLBP.
• Brain morphology deficits are associated with longer pain duration and poorer physical function.
• Brain structure and function may be key factors in chronic pain disability and represent potential therapeutic targets.