4.6 Article

Functional brain mapping in patients with chronic back pain shows age-related differences

期刊

PAIN
卷 163, 期 8, 页码 E917-E926

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/j.pain.0000000000002534

关键词

Chronic low back pain; Aging; fMRI; Multivariate searchlight

资金

  1. National Institute of Neurological Disorders and Stroke (NINDS)
  2. National Institute of Drug Abuse (NIDA)
  3. NIDA [5K08DA037525]
  4. Psychiatry Department at the Yale School of Medicine
  5. NINR [R01NR015452B]
  6. Psychiatry Department at the University of Rochester Medical Center

向作者/读者索取更多资源

Low back pain is a common and disabling condition in older adults. The cause of this chronic pain condition in older adults is unknown. This study explores the role of brain activity patterns in the emergence and experience of low back pain, and how these patterns differ between age groups. The results suggest that limbic brain areas play an increased role in older patients with low back pain.
Low back pain is the most common pain condition and cause for disability in older adults. Older adults suffering from low back pain are more disabled than their healthy peers, are more predisposed to frailty, and tend to be undertreated. The cause of increased prevalence and severity of this chronic pain condition in older adults is unknown. Here, we draw on accumulating data demonstrating a critical role for brain limbic and sensory circuitries in the emergence and experience of chronic low back pain (CLBP) and the availability of resting-state brain activity data collected at different sites to study how brain activity patterns predictive of CLBP differ between age groups. We apply a data-driven multivariate searchlight analysis to amplitude of low-frequency fluctuation brain maps to classify patients with CLBP with >70% accuracy. We observe that the brain activity pattern including the paracingulate gyrus, insula/secondary somatosensory area, inferior frontal, temporal, and fusiform gyrus predicted CLBP. When separated by age groups, brain patterns predictive of older patients with CLBP showed extensive involvement of limbic brain areas including the ventromedial prefrontal cortex, the nucleus accumbens, and hippocampus, whereas only anterior insula paracingulate and fusiform gyrus predicted CLBP in the younger patients. In addition, we validated the relationships between back pain intensity ratings and CLBP brain activity patterns in an independent data set not included in our initial patterns' identification. Our results are the first to directly address how aging affects the neural signature of CLBP and point to an increased role of limbic brain areas in older patients with CLBP.

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