Background & Aims

Sng is a prevalent complaint among Chinese speakers experiencing chronic low back pain (CLBP) to describe non-pain soreness symptoms. It is considered a distinct sensory experience compared to pain on a subjective level. Preliminary studies have revealed a positive association between back pain and physical health-related quality of life (HRQoL). In contrast, back sng has shown a negative association with mental HRQoL, highlighting significant differential clinical impacts between sng and pain. Therefore, exploring the impact of chronic sng on functional brain networks is a worthwhile endeavor. The purpose of this study is to explore the distinct impacts of chronic low back sng and pain perception on brain activity using resting-state fMRI.

Methods

This is a prospective observational study. Seventy-five patients with chronic low back sng VAS?3 or/and pain VAS?3 for over 12 weeks, classified into three CLBP types: sng-dominant (n=29), pain-dominant (n=16) and sng-pain (n=30), and thirty-seven healthy subjects participated in this study and underwent a resting-state brain fMRI examination. The questionnaires, including Sng Pain Visual Analog Scale (VAS), Oswestry Disability Index (ODI), RAND 36-Item Short Form Survey (SF-36) and Hospital Anxiety and Depression Scale (HADS) were used to assess HRQoL. Group independent component analysis with dual regression (GICA-DR) of fMRI images was used to detect resting-state networks (RSNs) and to investigate the significant differences between groups.

Results

The low back sng VAS scores were significantly higher in sng-dominant and sng-pain patients than in pain-dominant patients and healthy participants. Similarly, the low back pain VAS scores were significantly higher in pain-dominant and sng-pain patients than in sng-dominant patients and healthy participants. The ODI and HADS scores were significantly higher, and the SF36-PCS scores were significantly lower in all three types of CLBP patients than healthy participants, with no significant differences among three CLBP types. In SF36-MCS scores, sng-pain patients and healthy participants showed significantly higher scores than sng-dominant patients. Compared to pain-dominant patients (n=12), sng-dominant patients (n=19) presented hyperconnectivity in the insula-temporal-ACC network and cerebellum-thalamus network. However, the functional connectivity between ACC, insula, S1_3a, S1_3b and thalamus showed no significant differences among the three CLBP types and healthy participants (n=5).

Conclusions

The insula-temporal-ACC network and cerebellum-thalamus network are the potential imaged-based neural substrates to distinguish the impacts of sng from pain.

References

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Presenting Author

Chen-Ling Lan

Poster Authors

Chen-Ling Lan

Taipei Medical University Hospital

Lead Author

Yu-Chun Lo

Taipei Medical University Hospital

Lead Author

Ting-Chun Lin

Taipei Medical University Hospital

Lead Author

Yu-Wen Yu

Taipei Medical University Hospital

Lead Author

Li-Chun Hsieh

Taipei Medical University Hospital

Lead Author

Chih-Cheng Chen

Taipei Medical University Hospital

Lead Author

Jiann-Her Lin

MD, PhD

Taipei Medical University Hospital

Lead Author

Topics

  • Pain Imaging