Brain structural and functional alterations in chronic non-specific low back pain: A case-control study
Huibiao Li1, Xiaonan Zhan2, Xin Zhao3
1College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, China.
Musculoskeletal Science & Practice
|September 13, 2025
Summary
Chronic non-specific low back pain (CNLBP) is linked to changes in brain structure and function, including gray matter volume and functional connectivity. These brain alterations correlate with psychosocial factors like anxiety and depression in CNLBP patients.
Area of Science:
- Neuroscience
- Psychology
- Radiology
Background:
- The interplay between clinical symptoms, psychosocial factors, and brain changes in chronic non-specific low back pain (CNLBP) is not fully understood.
- Investigating structural and functional brain alterations offers insights into the mechanisms of CNLBP.
Purpose of the Study:
- To identify gray matter volume (GMV) changes in CNLBP patients.
- To examine resting-state functional connectivity (rsFC) alterations in specific brain regions.
- To correlate these brain changes with clinical symptoms and psychosocial factors.
Main Methods:
- Magnetic resonance imaging (MRI) was used to scan 30 CNLBP patients and 30 healthy controls.
- Voxel-based morphometry analyzed GMV differences, and whole-brain rsFC was assessed.
- Partial correlation and mediation analyses explored central nervous system mechanisms.
Main Results:
- CNLBP patients showed reduced GMV in the left precentral gyrus, lingual gyrus, and right cerebellum_Crus1.
- Altered rsFC was observed in the cerebellum-thalamus-precentral network and limbic system.
- These brain changes were associated with pain severity, disability, anxiety, depression, and pain catastrophizing.
Conclusions:
- CNLBP is associated with significant structural and functional brain changes.
- These brain alterations are linked to psychosocial factors, including anxiety, depression, and pain catastrophizing.
- Understanding these neurobiological changes can enhance our comprehension of CNLBP and its management.
