Structural, Functional and Neurochemical Cortical Brain Changes Associated with Chronic Low Back Pain

Medrano-Escalada, Yara; Plaza-Manzano, Gustavo; Fernández‐de‐las‐Peñas, César; Valera‐Calero, Juan Antonio

doi:10.3390/tomography8050180

Cited by 16 publications

(6 citation statements)

References 43 publications

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“…[24] Areas of decreased gray matter in individuals with back pain are most commonly reported to include the anterior cingulate and midcingulate cortices, primary and secondary somatosensory cortices, the insula, thalamus, superior frontal gyrus, striatum and middle occipital gyrus. [24,36,62,63] Based on our findings and those of earlier studies we speculate that in the early stages of persistent LBP, gray matter increases due to an initial neuroplastic response to greater usage and activation of areas associated with nociception and pain processing. Mechanisms underlying increased gray matter may include increased size/density of neurons, dendrites, synapses, and neurotransmitter receptors, increased local brain metabolism, increased extracellular water content, and vascular volume.…”

Section: Discussionsupporting

confidence: 75%

Gray matter morphology and pain-related disability in young adults with low back pain

Armour Smith,

Tain,

Chrisman

et al. 2024

Preprint

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Structural neuroplasticity in the brain may contribute to the persistence of low back pain (LBP) symptoms and the disability associated with them. It is not known if structural adaptations are evident early in the lifespan in young adults with LBP. This study compared gray matter in cortical sensorimotor regions in young adults with and without persistent LBP and identified gray matter and clinical predictors of pain-related disability. Eighty-two individuals with and without a history of LBP participated. Peak and average gray matter density in cortical sensorimotor regions of interest was quantified using voxel-based morphometry. Pain-related disability, pain intensity, pain duration, and pain-related fear were also assessed. Multiple linear regression was used to determine independent predictors of pain-related disability. We document significantly greater peak gray matter density in individuals with LBP in the primary somatosensory cortex, angular gyrus, and the midcingulate cortex. Pain-related disability positively correlated with average gray matter density in the posterior cingulate cortex. The most robust predictors of disability were average gray matter in the posterior cingulate, pain intensity, and pain-related fear. We demonstrate that in young adults, persistent LBP, and pain-related disability, are linked with structural neuroplasticity in regions forming part of the brain network termed the pain matrix. In contrast with studies of LBP in older adults, our findings of increased rather than decreased gray matter in young adults with LBP suggest that gray matter may increase initially in response to nociceptive pain.

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Section: Discussionsupporting

confidence: 75%

Gray matter morphology and pain-related disability in young adults with low back pain

Armour Smith,

Tain,

Chrisman

et al. 2024

Preprint

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“…З молекулярного погляду в розвитку ДЗД мають значення порушення ме таболічної ак тивнос ті та виживання клітин МХД, які регулюють низка факторів росту, збільшення ангіогенної активності та зменшення метаболічної проникності хрящових замикальних плас тинок МХ Д, зміна активнос ті апарату ремоделювання міжклітинного матриксу, р о з в и т о к т р и в а л о г о л о к а л ьн о г о з а п а л ьн о г о процесу з усіма факторними і к літинними його учасниками, важлива для формування хронічного болю вторинна понадіннервація МХД і сенситизація апарат у ноцицепції з дифузійним поширенням чинників сенситизації на прилеглі сегменти, а також морфологічні та функціональні зміни головного мозку на тлі хронічного болю [1, 3,6,7,9,10,17,20,21,25]. Крім цього, тривалий перебіг Д ЗД спричиняє зменшення висоти МХД, гіпертрофію поверхонь дуговідросткових суглобів та їхніх сумок, зменшення діаметра між хребцевих отворів і с тиснення їх судинно-нервового вмісту, тобто появу корінцевої симптоматики [6,21].…”

Section: патофізіологія дздunclassified

Clinical biomechanics of the spine in three unsolved problems. A brief analytical review

Medvediev,

Marushchenko

2024

Ukr Neurosurg J

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Chronic pathology of the spine, especially its forms, such as degenerative disc disease (DDD), is one of the most common in the human population and a marker for a person. Even though this pathology lacks the burden of mortality, its existence and consequences worsen the quality of life. Hypotheses of the high prevalence of DDD often appeal to a person's upright gait and the function of the spine as a movable vertical support, which means a permanent significant axial load of the intervertebral discs (IVDs). Therefore, finding out the magnitude of such a load, its dependence on the body's position in space, and types of motor activity is an essential practical task of the biomechanics of the spine as a separate interdisciplinary direction of biomedical research. Despite all the efforts and significant activity during the 70s and 80s of the last century, the central questions of clinical biomechanics of the spine still need to be explored. It is visible from the state of development of three "legendary" problems ‒ elucidation of intradiscal pressure against the background of usual types of physical activity, the role of sitting in the promotion of DDD of the lumbar region, and determination of the role of intra-abdominal pressure in reducing the axial load of this region of the spine. For example, the results of the investigations can state that assessment of intradiscal pressure against the background of human behavioral activity has so far been the focus of a disproportionately small number of works, which, due to the weakness of the accompanying visualization and the technical unreliability of the sensors did not obtain a sufficient empirical base for statistically significant conclusions. Therefore, the urgent task of the future is developing and using a more accurate, reliable, miniature, and durable intradiscal pressure monitoring technique, which would make it possible to evaluate this parameter on large samples of volunteers with conditionally intact IVD and against the background of pathology. In this regard, the assumptions about the role of sitting in the development of DDD of the lumbar spine remain unverified.Similarly, the research on the phenomenon of intra-abdominal pressure needs to determine under what conditions and mechanisms this factor can affect the magnitude of the axial load on the lumbar spine. Also, constructing more insightful models of the biomechanics of the spine is only possible with expanding ideas about the composition, vascularization, and innervation of the IVD, biology, and pathology of IVD cells. The practical outcome of all these studies is delineation of the most dangerous types of motor activity in the promotion of DDD, which will bring us closer to understanding the drivers of DDD and thus improving the means of preventing and treating this ubiquitous pathology.

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“…A growing interest is emerging about the changes that chronic pain could produce at the level of the cerebral cortex. Novel advances in neuroimaging techniques demonstrated structural, functional, and neurochemical changes [ 275 ].…”

Section: Neurosurgical Proceduresmentioning

confidence: 99%

Neurosurgical Treatment of Pain

Sola

Pulido

2022

Brain Sciences

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The aim of this review is to draw attention to neurosurgical approaches for treating chronic and opioid-resistant pain. In a first chapter, an up-to-date overview of the main pathophysiological mechanisms of pain has been carried out, with special emphasis on the details in which the surgical treatment is based. In a second part, the principal indications and results of different surgical approaches are reviewed. Cordotomy, Myelotomy, DREZ lesions, Trigeminal Nucleotomy, Mesencephalotomy, and Cingulotomy are revisited. Ablative procedures have a limited role in the management of chronic non-cancer pain, but they continues to help patients with refractory cancer-related pain. Another ablation lesion has been named and excluded, due to lack of current relevance. Peripheral Nerve, Spine Cord, and the principal possibilities of Deep Brain and Motor Cortex Stimulation are also revisited. Regarding electrical neuromodulation, patient selection remains a challenge.

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Structural, Functional and Neurochemical Cortical Brain Changes Associated with Chronic Low Back Pain

Cited by 16 publications

References 43 publications

Gray matter morphology and pain-related disability in young adults with low back pain

Gray matter morphology and pain-related disability in young adults with low back pain

Clinical biomechanics of the spine in three unsolved problems. A brief analytical review

Neurosurgical Treatment of Pain

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