Meier Michael L, Stämpfli Phillipp, Vrana Andrea, Humphreys Barry K, Seifritz Erich, Hotz-Boendermaker Sabina
Balgrist University Hospital Zurich, Switzerland ; Center of Dental Medicine, University of Zurich Zurich, Switzerland.
Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich Zurich, Switzerland ; MR-Center of the Psychiatric Hospital and Department of Child and Adolescent Psychiatry, University of Zurich Zurich, Switzerland.
Front Hum Neurosci. 2015 Jul 24;9:424. doi: 10.3389/fnhum.2015.00424. eCollection 2015.
In most individuals suffering from chronic low back pain, psychosocial factors, specifically fear avoidance beliefs (FABs), play central roles in the absence of identifiable organic pathology. On a neurobiological level, encouraging research has shown brain system correlates of somatic and psychological factors during the transition from (sub) acute to chronic low back pain. The characterization of brain imaging signatures in pain-free individuals before any injury will be of high importance regarding the identification of relevant networks for low back pain (LBP) vulnerability. Fear-avoidance beliefs serve as strong predictors of disability and chronification in LBP and current research indicates that back pain related FABs already exist in the general and pain-free population. Therefore, we aimed at investigating possible differential neural functioning between high- and low fear-avoidant individuals in the general population using functional magnetic resonance imaging. Results revealed that pain-free individuals without a history of chronic pain episodes could be differentiated in amygdala activity and connectivity to the pregenual anterior cingulate cortex by their level of back pain related FABs. These results shed new light on brain networks underlying psychological factors that may become relevant for enhanced disability in a future LBP episode.
在大多数患有慢性下背痛的个体中，心理社会因素，特别是恐惧回避信念（FABs），在没有可识别的器质性病变的情况下起着核心作用。在神经生物学层面，令人鼓舞的研究表明，在从（亚）急性下背痛转变为慢性下背痛的过程中，大脑系统与躯体和心理因素存在关联。在任何损伤之前对无痛个体的脑成像特征进行表征，对于识别与下背痛（LBP）易感性相关的网络至关重要。恐惧回避信念是LBP残疾和慢性化的有力预测指标，目前的研究表明，与背痛相关的FABs在普通人群和无痛人群中已经存在。因此，我们旨在使用功能磁共振成像研究普通人群中高恐惧回避和低恐惧回避个体之间可能存在的神经功能差异。结果显示，没有慢性疼痛发作史的无痛个体可以根据其与背痛相关的FABs水平，在杏仁核活动以及与膝前扣带回皮质的连接方面进行区分。这些结果为心理因素背后的脑网络提供了新的线索，这些脑网络可能与未来LBP发作时残疾程度的加重有关。
