Brain functional connectivity changes by low back extension pain model in low back pain patients

Area of Science:

• Neuroscience
• Pain Research
• Medical Imaging

Background:

• Low back pain (LBP) is a prevalent condition, often classified as 'non-specific,' making experimental modeling challenging.
• Existing experimental LBP models have limitations in replicating clinical pain and applicability in steady-state neuroimaging.
• There is a need for a reliable experimental LBP model that mimics patient pain and is suitable for neuroimaging.

Purpose of the Study:

• To develop a simple low back extension (LBE) pain model for inducing experimental LBP.
• To ensure the induced LBP in the model has similar properties to patients' clinical pain.
• To apply the LBE model in a steady-state neuroimaging study to assess its applicability.

Main Methods:

• The LBE pain model was evaluated in 217 LBP patients for pain reproducibility and similarity to clinical pain (STUDY1).
• The model was applied in a functional MRI study with 47 LBP patients and 23 healthy controls to assess applicability, including head motion and brain functional connectivity (STUDY2).

Main Results:

• 68.2% of LBP patients reported increased LBP with high sensory similarity to their clinical pain in STUDY1.
• Head motions in STUDY2 were similar to and correlated with resting-state motions.
• The LBE model induced significant changes in brain functional connectivity, decreasing default-mode and sensorimotor networks while increasing the salience network, correlating with pain intensity.

Conclusions:

• The developed LBE pain model successfully increases LBP with high patient-specific sensory similarity.
• The model induces patient-specific brain responses with acceptable head motion for neuroimaging.
• This LBE model is suitable for neuroimaging studies investigating brain responses to endogenous low back pain.