Changes in brain structure and function during early aging in patients with chronic low back pain

Area of Science:

• Neuroscience
• Radiology
• Pain Medicine

Background:

• Chronic low back pain (CLBP) is a prevalent condition affecting individuals across various age groups.
• Understanding the long-term neurological consequences of CLBP, particularly its interaction with the aging process, is crucial for comprehensive patient care.

Purpose of the Study:

• To investigate the structural and functional brain changes in cognition-related regions in patients with CLBP.
• To examine how the interplay between CLBP and age influences these brain alterations.

Main Methods:

• Recruited 76 CLBP patients, categorized into younger (20-29 years), middle (30-39 years), and older (40-49 years) age groups.
• Utilized functional magnetic resonance imaging (fMRI) for brain activity and connectivity analysis.
• Conducted clinical psychological and pain symptom assessments.

Main Results:

• Older CLBP patients showed reduced gray matter volume in the orbitofrontal cortex and superior frontal gyrus compared to younger patients.
• Significant differences in resting-state brain activity (ALFF) were observed in the postcentral gyrus and ventral medial prefrontal cortex in older patients.
• Decreased functional connectivity (FC) was noted in the right insula and dorsolateral prefrontal cortex in older patients, and in the parahippocampal gyrus and inferior parietal lobule in middle-aged and older patients.
• Brain structural properties and FC values correlated significantly with age.

Conclusions:

• CLBP appears to influence and potentially accelerate the brain's aging process.
• The synergistic effects of CLBP and aging hasten the decline in both function and structure of specific brain regions.
• These changes may affect not only pain processing but also contribute to cognitive impairments.