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 23 publications

(16 citation statements)

References 43 publications

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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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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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“…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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“…Studies suggest that structural and functional changes within the brain are associated with chronic low back pain (cLBP) [ 1 ], [ 2 ], [ 3 ]. Recent magnetic resonance imaging (MRI) studies reveal changes in functional connectivity, the volume of gray matter, and white matter integrity in people with cLBP, specifically within brain regions such as primary sensorimotor cortices (S1/M1), secondary somatosensory area (S2), medial and dorsolateral prefrontal cortex, and anterior and posterior cingulate cortex [ 4 ], [ 5 ], [ 6 ], [ 7 ], [ 8 ]. These cortical alterations might contribute to impaired sensorimotor control in this population.…”

Section: Introductionmentioning

confidence: 99%

MRI Compatible Lumbopelvic Movement Measurement System to Validate and Capture Task Performance During Neuroimaging

Song,

Sunday,

Silfies

et al. 2024

IEEE Trans. Neural Syst. Rehabil. Eng.

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Research suggests that structural and functional changes within the brain are associated with chronic low back pain, and these cortical alterations might contribute to impaired sensorimotor control of the trunk and hips in this population. However, linking sensorimotor brain changes with altered movement of the trunk and hips during task-based neuroimaging presents significant challenges. An MRI-safe pressure measurement system was developed to ensure proper task completion during neuroimaging by capturing movement patterns of the trunk (sensors under the lower back) and hips (sensors embedded in the foam roll under the knees). Pressure changes were measured outside of the scanner by digital differential pressure sensors to capture time-series data and analog pressure gauges for real-time determination of task performance occurring within an MRI bore during brain imaging. This study examined the concurrent validity of air pressure changes between the digital and analog sensors. The digital and analog data were compared in 23 participants during the performance of modified bilateral and unilateral right and left hip bridges. Spearman’s correlations were calculated for each sensor during the three bridging tasks and showed high positive correlations, indicating that over 87% of pressure change from the analog gauge can be explained by the pressure from the digital sensor. Bland-Altman plots showed no bias and mean differences were under three mmHg. This pressure system improves the rigor of future studies by validating the digital data from the system and increasing the capabilities of capturing lumbopelvic task performance occurring inside the scanner bore.

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

Cited by 23 publications

References 43 publications

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

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

Neurosurgical Treatment of Pain

MRI Compatible Lumbopelvic Movement Measurement System to Validate and Capture Task Performance During Neuroimaging

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