School of Psychology, University of Queensland, Brisbane, QLD, Australia.
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.
Pain Med. 2021 Aug 6;22(8):1804-1813. doi: 10.1093/pm/pnab049.
Psychological treatments for chronic low back pain (CLBP) are effective. However, limited research has investigated their neurophysiological mechanisms. This study examined electroencephalography- (EEG-) assessed brain oscillation changes as potential mechanisms of cognitive therapy (CT), mindfulness-meditation (MM), and mindfulness-based cognitive therapy (MBCT) for CLBP. The a priori bandwidths of interest were changes in theta, alpha and beta power, measured at pre- and post-treatment.
A secondary analysis of a clinical trial.
University of Queensland Psychology Clinic.
Adults (N = 57) with CLBP who completed pre- and post-treatment EEG and pain outcome assessments.
EEG data were examined for five regions of interest (ROIs); the primary outcome was pain intensity.
A significant reduction in theta (P=.015) and alpha (P=.006) power in the left frontal ROI across all treatments was found, although change in theta and alpha power in this region was not differentially associated with outcome across treatments. There were significant reductions in beta power in all five ROIs across all treatments (P≤.013). Beta power reduction in the central ROI showed a significant association with reduced pain intensity in MBCT only (P=.028). Changes in other regions were not statistically significant.
These findings provide support for the capacity of psychological CLBP treatments to induce changes in brain activity. The reduced beta power in all five ROIs indicated that all three treatments engendered a state of lowered cortical arousal. The growing body of research in this area could potentially inform novel directions towards remedying central nervous system abnormalities associated with CLBP.
针对慢性下背痛（CLBP）的心理治疗是有效的。然而，有限的研究调查了其神经生理机制。本研究通过脑电（EEG）评估脑震荡变化，以探讨认知治疗（CT）、正念冥想（MM）和正念认知疗法（MBCT）治疗 CLBP 的潜在机制。感兴趣的先验带宽是治疗前后的θ、α和β功率变化。
临床试验的二次分析。
昆士兰大学心理学诊所。
完成治疗前后 EEG 和疼痛结果评估的 CLBP 成年人（N=57）。
对五个感兴趣的脑区（ROI）进行 EEG 数据分析；主要结果是疼痛强度。
在所有治疗中，左额 ROI 的θ（P=.015）和α（P=.006）功率均显著降低，尽管该区域的θ和α功率变化与治疗之间的结果无差异相关。在所有治疗中，五个 ROI 的β功率均显著降低（P≤.013）。仅在 MBCT 中，中央 ROI 的β功率降低与疼痛强度降低呈显著相关性（P=.028）。其他区域的变化没有统计学意义。
这些发现为心理 CLBP 治疗能够诱导大脑活动变化提供了支持。所有五个 ROI 的β功率降低表明，三种治疗方法都引起了皮质兴奋度的降低。该领域不断增加的研究可能为纠正与 CLBP 相关的中枢神经系统异常提供新的方向。
