Alteration of low frequency fluctuation amplitude at brain-resting state in patients with chronic discogenic low back pain / 中国组织工程研究

ABSTRACT

BACKGROUND: Neuroimaging studies have shown that chronic pain could cause functional and structural alterations; however, the neural mechanism of psychosomatic symptoms caused by chronic discogenic low back pain (CDLBP) remains unclear. OBJECTIVE: To investigate the alterations of amplitude of low frequency fluctuation (ALFF) of resting spontaneous brain activity in CDLBP patients and their relationships with clinical symptoms. METHODS: Resting-state brain functional MRI scans were performed in 67 CDLBP patients (CDLBP group) and 78 age-, sex-and education level-matched healthy controls (control group). The disease course, Visual Analogue Scale score, Oswestry Disability Index and Self-rating Depression Scale score were analyzed for CDLBP patients. The average ALFF values of the two groups were calculated using DPARSF and REST software, the differences of ALFF values between the two groups were compared by independent two-sample t-test, and the relationships between the ALFF values derived from significant regions and the course of disease and clinical symptoms were analyzed. The study protocol was approved by the Ethics Committee of Second Affiliated Hospital of Xinxiang Medical University (approval No. 20150210). RESULTS AND CONCLUSION: Compared with the control group, the regions with significantly increased ALFF values in the CDLBP group included the left insular lobe, right parahippocampal gyrus, bilateral superior temporal gyrus, left inferior temporal gyrus, bilateral prefrontal lobe, left caudate nucleus and right inferior frontal gyrus (all P < 0.05, Gaussian random field (GRF) corrected). Compared with the control group, the regions with significantly decreased ALFF values in the CDLBP group included the right superior orbital frontal gyrus and right lingual gyrus (both P <0.05, GRF corrected). Correlation analysis showed that the mean ALFF values in the right inferior frontal gyrus and left caudate nucleus were positively correlated with the Visual Analogue Scale (all P < 0.05). All these findings suggest that patients with CDLBP have abnormal spontaneous brain activities in multiple brain regions, and these alterations are correlated with the degree of pain.