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Dynamic Quantitative Sensory Testing to Characterize Central Pain Processing
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Transcriptomic decoding of dynamic brain activity alterations in chronic non-specific low back pain.

Jiacheng Liu1,2,3, Peng Lai1,2,3, Xingyao Chen4

  • 1Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

Regional Anesthesia and Pain Medicine
|June 10, 2026
PubMed
Summary

Chronic low back pain alters brain activity dynamics, linking specific neural states to gene expression. This research reveals how brain function changes in pain and connects it to biological pathways.

Keywords:
Back PainCHRONIC PAINCLINICAL PAINDiagnostic ImagingMultimodal Imaging

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Area of Science:

  • Neuroscience
  • Medical Imaging
  • Genomics

Background:

  • Dynamic brain fluctuations are crucial for understanding disease-related neural activity changes.
  • Chronic non-specific low back pain (CNLBP) involves altered brain function, but dynamic changes and gene expression links remain unclear.

Purpose of the Study:

  • To investigate dynamic brain activity patterns in CNLBP using resting-state fMRI.
  • To explore the relationship between altered neural dynamics and gene expression profiles in CNLBP patients.

Main Methods:

  • Applied a hidden Markov model (HMM) to resting-state fMRI data from 80 CNLBP patients and 80 healthy controls (HCs).
  • Utilized partial least squares analysis to link neural dynamics metrics (FO, LT, MDT, TP, SR) with gene expression from the Allen Human Brain Atlas.
  • Performed enrichment analyses to identify biological pathways associated with aberrant brain dynamics.

Main Results:

  • Identified eight distinct HMM brain states; CNLBP patients showed altered state occupancies and transitions (e.g., reduced MDT in state 3, increased MDT in state 6, reduced FO/LT/MDT in state 7).
  • State 7 in CNLBP exhibited abnormal dynamics with increased salience/sensorimotor network activity and decreased default mode network activity.
  • State 7 activation correlated with gene expression, with enrichment analysis highlighting nociceptive and inflammatory pathways.

Conclusions:

  • CNLBP is associated with complex alterations in dynamic brain activity, particularly in HMM state 7.
  • Linked aberrant temporal features of brain state 7 to specific gene expression profiles in CNLBP.
  • Findings offer new insights into CNLBP's neural basis and its connection to gene expression, implicating pain and inflammation pathways.