Zhang Shan-Shan, Wu Wen, Yang Jian-Ming, Wang Chu-Huai
From the Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR China (SZ, CW); and Departments of Rehabilitation Medicine (WW) and Radiology (JY), Zhujiang Hospital, Southern Medical University, Guangzhou, PR China.
Am J Phys Med Rehabil. 2017 Apr;96(4):253-259. doi: 10.1097/PHM.0000000000000597.
Neuroimaging studies have revealed that low-back pain (LBP) alters spatiotemporal dynamics of the blood oxygen level-dependent signal in response to persistent noxious stimulus. This study aimed to investigate changes in spontaneous neural activity of various brain regions in acute LBP using resting-state functional magnetic resonance imaging and amplitude of low-frequency fluctuation (ALFF).
Twelve healthy subjects underwent two separate resting-state functional magnetic resonance imaging scans at health status as baseline and after intramuscular injection of hypertonic saline (0.5 mL, 5%) into the back muscles to induce acute LBP.
Compared with baseline, acute LBP showed decreased ALFF in the right posterior cingulate cortex/precuneus and left primary somatosensory cortex (S1) but increased ALFF in the right medial prefrontal cortex, right middle temporal gyrus, bilateral inferior temporal gyrus, bilateral insula, right anterior cingulate cortex, and left cerebellum. In addition, significant negative correlations were observed between visual analog scale scores and ALFF of the bilateral medial prefrontal cortex, left inferior frontal gyrus, left S1, right anterior cingulate cortex, and left middle temporal gyrus.
These findings suggest that abnormally spontaneous neural activity involving some brain regions are responsible for sensory, affective, and cognitive functions, which may be implicated in the underlying pathophysiology of acute LBP.
神经影像学研究表明，下背痛（LBP）会改变对持续性有害刺激的血氧水平依赖信号的时空动态。本研究旨在利用静息态功能磁共振成像和低频波动幅度（ALFF）来研究急性LBP患者不同脑区自发神经活动的变化。
12名健康受试者在健康状态下作为基线进行了两次单独的静息态功能磁共振成像扫描，并在背部肌肉内注射高渗盐水（0.5 mL，5%）以诱发急性LBP后再次进行扫描。
与基线相比，急性LBP患者右侧后扣带回皮质/楔前叶和左侧初级躯体感觉皮质（S1）的ALFF降低，但右侧内侧前额叶皮质、右侧颞中回、双侧颞下回、双侧脑岛、右侧前扣带回皮质和左侧小脑的ALFF升高。此外，在视觉模拟量表评分与双侧内侧前额叶皮质、左侧额下回、左侧S1、右侧前扣带回皮质和左侧颞中回的ALFF之间观察到显著的负相关。
这些发现表明，涉及某些脑区的异常自发神经活动与感觉、情感和认知功能有关，这可能与急性LBP的潜在病理生理学有关。
