Neural Responses of Posterior to Anterior Movement on Lumbar Vertebrae: A Functional Magnetic Resonance Imaging Study

Meier, Michael L.; Hotz‐Boendermaker, Sabina; Boendermaker, Bart; Luechinger, Roger; Humphreys, B. Kim

doi:10.1016/j.jmpt.2013.09.004

Cited by 15 publications

(12 citation statements)

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“…6,19 Such sensory information is the basis for body perception and mandatory for neural control of the lumbar spine. 6,7 The present investigation confirmed that PA pressure induced a consistent activation pattern in the right S1 and indicated a similar representation of mechanosensory input of the lumbar spine in S1 in both the control and the CLBP group. The right hemispheric preference for processing mechanosensory spinal input is not a novel finding.…”

Section: Discussionsupporting

confidence: 82%

“…In healthy individuals, we have recently reported cortical processing of a nonpainful manual technique, that is, posterior-to-anterior (PA) pressure onto lumbar vertebrae. 6,7 Strong and consistent activation were detected bilaterally in the somatosensory cortices by using functional magnetic resonance imaging (fMRI). Between individual subjects, the activation maps in the primary somatosensory cortex (S1) were remarkably robust, although individual lumbar vertebrae were not somatotopically represented.…”

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confidence: 99%

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Reorganization in Secondary Somatosensory Cortex in Chronic Low Back Pain Patients

Hotz‐Boendermaker

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Meier

et al. 2016

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STUDY DESIGN: A cross-sectional comparative study between chronic low back pain (CLBP) patients and healthy control subjects. OBJECTIVE: The aim of this study was to investigate reorganization in the sensory cortex by comparing cortical activity due to mechanosensory stimulation of the lumbar spine in CLBP patients versus a control group by using functional magnetic resonance imaging (fMRI). SUMMARY OF BACKGROUND DATA: LBP is now the number 1 condition across the world in terms of years living with a disability. There is growing evidence that maladaptive changes in the processing of sensory input by the central nervous system are central to understanding chronic (back) pain. METHODS: Nonpainful, posterior-anterior (PA) movement pressure was applied manually to lumbar vertebrae at L1, L3, and L5 in 13 healthy subjects and 13 CLBP patients. The manual pressure (30 N) was monitored and controlled using sensors. A randomized stimulation protocol was used consisting of 51 pressure stimuli of 5 seconds duration. fMRI data analysis was performed for the group activation within the primary and secondary sensory cortices (S1 and S2, respectively) and the representation of the individual vertebrae was extracted and statistically analyzed. RESULTS: Nonpainful PA pressure revealed no cortical reorganization in S1. In contrast, the extent of S2 activation in the CLBP group was significantly reduced in both hemispheres. In the control group, a somatotopy was identified for the lumbar vertebrae between L1 and L3, respectively, and L5 in S2 of the right hemisphere. Most importantly, a blurring of the somatotopic representation of the lumbar spine in S2 was observed in the patient group. CONCLUSION: Together, these maladaptive changes suggest a reorganization of higher-order processing for sensory information in CLBP patients that might have implications for a decreased sensory acuity, also related to body perception and subsequent altered functioning of the lumbar spine. LEVEL OF EVIDENCE: 2. Study Design. A cross-sectional comparative study between chronic low back pain (CLBP) patients and healthy control subjects.Objective. The aim of this study was to investigate reorganization in the sensory cortex by comparing cortical activity due to mechanosensory stimulation of the lumbar spine in CLBP patients versus a control group by using functional magnetic resonance imaging (fMRI). Summary of Background Data. LBP is now the number 1 condition across the world in terms of years living with a disability. There is growing evidence that maladaptive changes in the processing of sensory input by the central nervous system are central to understanding chronic (back) pain. Methods. Nonpainful, posterior-anterior (PA) movement pressure was applied manually to lumbar vertebrae at L1, L3, and L5 in 13 healthy subjects and 13 CLBP patients. The manual pressure (30 N) was monitored and controlled using sensors. A randomized stimulation protocol was used consisting of 51 pressure stimuli of 5 seconds duration. fMRI data analysis was ...

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Section: Discussionsupporting

confidence: 82%

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confidence: 99%

Reorganization in Secondary Somatosensory Cortex in Chronic Low Back Pain Patients

Hotz‐Boendermaker

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Meier

et al. 2016

Spine

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“…whole-body activities as presented in the current study, there is also considerable evidence for the involvement of SMA in postural control especially in anticipatory postural adjustments (APAs) and related body balance control [ 54 , 55 ]. In particular, SMA was activated when pressure stimuli were applied to the lumbar spine indicating fine scaled motor preparation/trunk stabilization mechanisms in the absence of an intended or actual performance, verifying the crucial role of this region in anticipatory postural control [ 56 ]. In chronic LBP patients, Jacobs and colleagues revealed delayed APAs suggesting a decrease in postural control and stability [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Differential Neural Processing during Motor Imagery of Daily Activities in Chronic Low Back Pain Patients

et al. 2015

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Chronic low back pain (chronic LBP) is both debilitating for patients but also a major burden on the health care system. Previous studies reported various maladaptive structural and functional changes among chronic LBP patients on spine- and supraspinal levels including behavioral alterations. However, evidence for cortical reorganization in the sensorimotor system of chronic LBP patients is scarce. Motor Imagery (MI) is suitable for investigating the cortical sensorimotor network as it serves as a proxy for motor execution. Our aim was to investigate differential MI-driven cortical processing in chronic LBP compared to healthy controls (HC) by means of functional magnetic resonance imaging (fMRI). Twenty-nine subjects (15 chronic LBP patients, 14 HC) were included in the current study. MI stimuli consisted of randomly presented video clips showing every-day activities involving different whole-body movements as well as walking on even ground and walking downstairs and upstairs. Guided by the video clips, subjects had to perform MI of these activities, subsequently rating the vividness of their MI performance. Brain activity analysis revealed that chronic LBP patients exhibited significantly reduced activity compared to HC subjects in MI-related brain regions, namely the left supplementary motor area and right superior temporal sulcus. Furthermore, psycho-physiological-interaction analysis yielded significantly enhanced functional connectivity (FC) between various MI-associated brain regions in chronic LBP patients indicating diffuse and non-specific changes in FC. Current results demonstrate initial findings about differences in MI-driven cortical processing in chronic LBP pointing towards reorganization processes in the sensorimotor network.

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“…As LBP is thought to be a mechanical disorder (Kobayashi et al., ), the application of a controlled and clinically relevant stimulus to the lower back is appropriate and important. However, motion artifacts restricted this functional magnetic resonance imaging (fMRI) experiment to the investigation of only nonpainful pressure stimuli (instead of painful stimulation) (Gervain et al., ; Meier, Hotz‐Boendermaker, Boendermaker, Luechinger, & Humphreys, ). Therefore, this study aimed at using functional near‐infrared spectroscopy (fNIRS) to measure cerebral hemodynamic responses, as fNIRS is more robust against motion artifacts as fMRI.…”

Section: Introductionmentioning

confidence: 99%

Different mechanosensory stimulations of the lower back elicit specific changes in hemodynamics and oxygenation in cortical sensorimotor areas—AfNIRSstudy

et al. 2016

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Background and ObjectivesThis study aimed at investigating the feasibility of functional near‐infrared spectroscopy (fNIRS) to measure changes in cerebral hemodynamics and oxygenation evoked by painful and nonpainful mechanosensory stimulation on the lower back. The main objectives were to investigate whether cortical activity can be (1) detected using functional fNIRS, and (2) if it is possible to distinguish between painful and nonpainful pressure as well as a tactile brushing stimulus based on relative changes in oxy‐ and deoxyhemoglobin ([O2Hb] and [HHb]).MethodsTwenty right‐handed subjects (33.5 ± 10.7 years; range 20–61 years; 8 women) participated in the study. Painful and nonpainful pressure stimulation was exerted with a thumb grip perpendicularly to the spinous process of the lumbar spine. Tactile stimulation was realized by a one‐finger brushing. The supplementary motor area (SMA) and primary somatosensory cortex (S1) were measured bilaterally using a multichannel continuous‐wave fNIRS imaging system.ResultsCharacteristic relative changes in [O2Hb] in the SMA and S1 after both pressure stimulations (corrected for multiple comparison) were observed. [HHb] showed only much weaker changes (uncorrected). The brushing stimulus did not reveal any significant changes in [O2Hb] or [HHb].ConclusionThe results indicate that fNIRS is sensitive enough to detect varying hemodynamic responses to different types of mechanosensory stimulation. The acquired data will serve as a foundation for further investigations in patients with chronic lower back pain. The future aim is to disentangle possible maladaptive neuroplastic changes in sensorimotor areas during painful and nonpainful lower back stimulations based on fNIRS neuroimaging.

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Neural Responses of Posterior to Anterior Movement on Lumbar Vertebrae: A Functional Magnetic Resonance Imaging Study

Cited by 15 publications

References 41 publications

Reorganization in Secondary Somatosensory Cortex in Chronic Low Back Pain Patients

Reorganization in Secondary Somatosensory Cortex in Chronic Low Back Pain Patients

Differential Neural Processing during Motor Imagery of Daily Activities in Chronic Low Back Pain Patients

Different mechanosensory stimulations of the lower back elicit specific changes in hemodynamics and oxygenation in cortical sensorimotor areas—AfNIRSstudy

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