Neurobiological Substrates of Chronic Low Back Pain (CLBP): a Brain [Tc]Tc-ECD SPECT Study

Overview

Journal Eur J Hybrid Imaging

Date 2022 Nov 20

PMID 36404393

Authors

Erica Negrini Lia

Priscila Colavite Papassidero

Eduardo Barbosa Coelho

Fabiola Dach

Leonardo Alexandre-Santos

Ana Carolina Trevisan

Lucas Emmanuel Lopes E Santos

Jose Henrique Silvah

Vera Lucia Lanchote

Oscar Della Pasqua

Lauro Wichert-Ana

Affiliations

Soon will be listed here.

Abstract

Background: Recent neuroimaging studies have demonstrated pathological mechanisms related to cerebral neuroplasticity in chronic low back pain (CLBP). Few studies have compared cerebral changes between patients with and without pain in the absence of an experimentally induced stimulus. We investigated the neurobiological substrates associated with chronic low back pain using [Tc]Tc-ECD brain SPECT and correlated rCBF findings with the numeric rating scale (NRS) of pain and douleur neuropathique en 4 questions (DN4). Ten healthy control volunteers and fourteen patients with neuropathic CLBP due to lumbar disc herniation underwent cerebral SPECT scans. A quantitative comparison of rCBF findings between patients and controls was made using the Statistical Parametric Mapping (SPM), revealing clusters of voxels with a significant increase or decrease in rCBF. The intensity of CLBP was assessed by NRS and by DN4.

Results: The results demonstrated an rCBF increase in clusters A (occipital and posterior cingulate cortex) and B (right frontal) and a decrease in cluster C (superior parietal lobe and middle cingulate cortex). NRS scores were inversely and moderately correlated with the intensity of rCBF increase in cluster B, but not to rCBF changes in clusters A and C. DN4 scores did not correlate with rCBF changes in all three clusters.

Conclusions: This study will be important for future therapeutic studies that aim to validate the association of rCBF findings with the pharmacokinetic and pharmacodynamic profiles of therapeutic challenges in pain.

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