Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, box 1501, Leuven 3001, Belgium.
Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, box 1501, Leuven 3001, Belgium; REVAL Rehabilitation Research Center, Hasselt University, Agoralaan A, Diepenbeek 3590, Belgium.
Neuroimage Clin. 2019;23:101881. doi: 10.1016/j.nicl.2019.101881. Epub 2019 May 28.
Patients with non-specific low back pain (NSLBP) show an impaired postural control during standing and a slower performance of sit-to-stand-to-sit (STSTS) movements. Research suggests that these impairments could be due to an altered use of ankle compared to back proprioception. However, the neural correlates of these postural control impairments in NSLBP remain unclear. Therefore, we investigated brain activity during ankle and back proprioceptive processing by applying local muscle vibration during functional magnetic resonance imaging in 20 patients with NSLBP and 20 controls. Correlations between brain activity during proprioceptive processing and (Airaksinen et al., 2006) proprioceptive use during postural control, evaluated by using muscle vibration tasks during standing, and (Altmann et al., 2007) STSTS performance were examined across and between groups. Moreover, fear of movement was assessed. Results revealed that the NSLBP group performed worse on the STSTS task, and reported more fear compared to healthy controls. Unexpectedly, no group differences in proprioceptive use during postural control were found. However, the relationship between brain activity during proprioceptive processing and behavioral indices of proprioceptive use differed significantly between NSLBP and healthy control groups. Activity in the right amygdala during ankle proprioceptive processing correlated with an impaired proprioceptive use in the patients with NSLBP, but not in healthy controls. Moreover, while activity in the left superior parietal lobule, a sensory processing region, during back proprioceptive processing correlated with a better use of proprioception in the NSLBP group, it was associated with a less optimal use of proprioception in the control group. These findings suggest that functional brain changes during proprioceptive processing in patients with NSLBP may contribute to their postural control impairments.
非特异性下腰痛（NSLBP）患者在站立时表现出姿势控制受损，并且完成坐-站-坐（STSTS）运动的速度较慢。研究表明，这些损伤可能是由于踝关节与背部本体感觉的使用改变所致。然而，NSLBP 患者姿势控制损伤的神经相关性尚不清楚。因此，我们通过在功能磁共振成像期间应用局部肌肉振动，研究了 20 名 NSLBP 患者和 20 名对照者在踝关节和背部本体感觉处理过程中的大脑活动。我们通过在站立时使用肌肉振动任务，评估了本体感觉处理过程中的大脑活动与（Airaksinen 等人，2006 年）姿势控制中本体感觉使用的相关性，以及与（Altmann 等人，2007 年）STSTS 表现的相关性，并对组内和组间进行了分析。此外，还评估了运动恐惧。结果表明，NSLBP 组在 STSTS 任务中的表现更差，并且比健康对照组报告了更多的运动恐惧。出乎意料的是，在姿势控制期间，我们没有发现本体感觉使用方面的组间差异。然而，本体感觉处理过程中的大脑活动与本体感觉使用的行为指标之间的关系在 NSLBP 组和健康对照组之间存在显著差异。在踝关节本体感觉处理过程中，右侧杏仁核的活动与患者本体感觉使用受损相关，而与健康对照组无关。此外，虽然在背部本体感觉处理过程中左顶叶上回（一个感觉处理区域）的活动与 NSLBP 组本体感觉的更好使用相关，但与对照组中本体感觉的不太理想使用相关。这些发现表明，NSLBP 患者在本体感觉处理过程中的功能性大脑变化可能导致他们的姿势控制受损。
