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Correlation between gene expression and MRI STIR signals in patients with chronic low back pain and Modic changes

Maria Dehli Vigeland1,2, Siri Tennebø Flåm3, Magnus Dehli Vigeland4,3

  • 1Division of Clinical Neuroscience, Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway. mariadvi@uio.no.

Scientific Reports
|January 8, 2022
PubMed

Insights

Chronic low back pain with Modic changes involves inflammation. Gene expression analysis in blood revealed immune defense pathways are active in these vertebral bone marrow lesions.

Area of Science:

  • Biomedical research
  • Molecular biology
  • Radiology

Background:

  • Chronic low back pain (LBP) significantly impacts patients and society, often without clear pathoanatomical causes.
  • Modic changes (MC), vertebral bone marrow lesions seen on MRI, are present in a subset of LBP patients, but their etiology and pain association remain unclear.
  • MC Type I represents the most inflammatory state, making it a key focus for understanding MC pathobiology.

Purpose of the Study:

  • To investigate the underlying pathobiology of Modic changes (MC) in chronic low back pain (LBP).
  • To explore the relationship between gene expression in blood and edema characteristics in MC Type I lesions.
  • To identify biological pathways involved in the development and progression of MC.

Main Methods:

  • Collected STIR MRI images and whole blood RNA from 96 patients with chronic LBP and MC Type I.
  • Performed gene expression profiling on blood samples.
  • Correlated gene expression data with MRI-derived edema parameters (signal volume, height, intensity).

Main Results:

  • Identified 37 genes significantly associated with STIR signal volume, indicating a link between gene expression and lesion size.
  • Found 10 genes associated with edema abundancy, suggesting a molecular basis for fluid accumulation in MC.
  • Discovered one gene significantly correlated with maximum STIR signal intensity, pointing to specific molecular markers of inflammation.
  • Enriched gene sets related to interferon signaling, mitochondrial metabolism, and viral defense response were identified.

Conclusions:

  • Inflammation and immunological defense mechanisms are crucial components of Modic change biology in chronic LBP patients.
  • Gene expression profiling in blood offers insights into the pathobiology of vertebral bone marrow lesions.
  • Further research into these immune pathways may reveal novel therapeutic targets for LBP associated with Modic changes.

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