Brain Network Changes in Lumbar Disc Herniation Induced Chronic Nerve Roots Compression Syndromes

Area of Science:

• Neuroscience
• Radiology
• Orthopedics

Background:

• Lumbar disc herniation (LDH) is a common cause of nerve compression syndromes.
• Chronic sciatica associated with LDH involves complex neural mechanisms and changes in brain function.
• Understanding these brain alterations is crucial for managing persistent pain.

Purpose of the Study:

• To investigate alterations in brain functional networks in patients with LDH-induced chronic sciatica.
• To utilize graph theory analysis to assess changes in brain network properties.

Main Methods:

• Functional MRI (fMRI) was used to scan 30 LDH patients and 30 healthy controls (HC).
• Whole-brain functional networks were constructed using Pearson's correlation.
• Graph theory metrics, including nodal centralities (degree centrality, betweenness centrality, nodal efficiency), were calculated and compared.

Main Results:

• Both LDH and HC groups exhibited small-world brain network architecture.
• LDH patients showed increased nodal centralities in the opercular inferior frontal gyrus.
• Decreased nodal centralities were observed in the orbital inferior frontal gyrus, lingual cortex, and inferior occipital gyrus in LDH patients.
• Reduced connectivity in the right inferior occipital gyrus correlated negatively with disability scores.

Conclusions:

• LDH-related chronic sciatica induces regional brain alterations affecting self-referential, emotional, and pain regulation functions.
• The overall small-world architecture of the brain network remains largely undisturbed.
• These findings offer novel perspectives on the neural underpinnings of radicular symptoms in LDH patients.