Neural activity during cognitive reappraisal in chronic low back pain: a preliminary study

Abstract

Objectives Chronic pain patients often report higher levels of negative emotions, suggesting reduced ability to regulate emotions effectively, however, little is known of the underlying neural cognitive mechanisms. Therefore, the aim of this study was to explore brain activity and connectivity during cognitive reappraisal in chronic low back pain (CLBP). Methods This study recruited 24 female participants; 12 with CLBP and 12 healthy controls. Participants completed an emotion regulation task that involved cognitive reappraisal of negative images during functional magnetic resonance imaging. The negative affect following each image and perceived success of the task were reported. Region of interest and seed-to-voxel analyses were conducted using key regions involved in cognitive reappraisal (i.e., amygdalae and dorsomedial prefrontal cortex) as seed regions. Results During the task, there were no group differences in the behavioural measures and blood oxygen level-dependent (BOLD) brain activation in the seed regions. Functional connectivity analysis showed reduced coupling between the amygdalae and dorsolateral prefrontal cortex, orbitofrontal cortex and inferior parietal cortex in the CLBP group compared to controls. Connectivity between the amygdala and inferior parietal cortex positively correlated with the percent of reduced negative affect during reappraisal in the CLBP group. Conclusions These preliminary findings demonstrate that individuals with CLBP exhibit similar emotion regulation abilities to healthy controls at the behavioural and BOLD level. However, altered functional connectivity observed in the CLBP group may reduce effective cognitive reappraisal. These results provide evidence for the potential clinical impact of network changes in CLBP.

Case report: The promising application of dynamic functional connectivity analysis on an individual with failed back surgery syndrome

“…Widespread findings have been found in the current literature. In general, cLBP patients showed decreased FC within the DMN (Kornelsen et al, 2013;Jiang et al, 2016;Ayoub et al, 2019;Ng et al, 2021a), along with increased FC between the DMN and other networks, including the emotional, cognitive, and/or central executive networks (Kornelsen et al, 2013;Jiang et al, 2016;Ma et al, 2020;Ng et al, 2021b;Mao et al, 2022b,c) in static FC studies. Particularly, medial prefrontal cortex (mPFC) seems playing an important role in cLBP (Baliki et al, 2011(Baliki et al, , 2014Yu et al, 2014).…”

Effectiveness of cognitive reappraisal and distraction for induced acute pain: A laboratory study.

“…Future studies would be needed to replicate these results in pediatric and elderly population suffering from acute pain and in patients with chronic pain, which could be of great clinical relevance for better pain management. Previous studies carried out with patients with chronic pain have shown that distraction is effective in the short term for adequate pain management by reducing perceived pain intensity scores (Jones et al, 2018; Matheve et al, 2020; Van Ryckeghem et al, 2018), whereas cognitive reappraisal has been associated with a better management of pain-related negative emotional states (Koechlin et al, 2018; Ng et al, 2021).…”

“…The implementation of this ER strategy requires subjects to perceive that they can control pain sensations (Ford & Gross, 2018). For patients with chronic pain, the use of cognitive reappraisal has been associated with less negative affect (Ng et al, 2021; Serrano-Ibáñez et al, 2018), greater positive affect (Serrano-Ibáñez et al, 2018), and less pain interference (Vertsberger et al, 2023), albeit no significant associations between cognitive reappraisal and perceived pain intensity have been found (Koechlin et al, 2018; Vertsberger et al, 2023).…”

Postural Control of Patients with Low Back Pain Under Dual-Task Conditions

“…Notability, based on the interaction between pain and cognition, long-term pain would be accompanied by cognitive impairments such as attention, reaction speed, and executive function. 53 , 54 For patients with low back pain, pain may interfere with cognition, leading to insufficient attention resources, resulting in decreased postural control and poor motor performance.…”