Department of Neurobiology and Collaborative Innovation Center for Brain Science, School of Basic Medicine, The Fourth Military Medical University, Xi'an, China.
College of Life Sciences, Northwest University, Xi'an, China.
Neural Plast. 2024 Mar 18;2024:5599046. doi: 10.1155/2024/5599046. eCollection 2024.
Low back pain (LBP) is a leading cause of global disabilities. Numerous molecular, cellular, and anatomical factors are implicated in LBP. Current issues regarding neurologic alterations in LBP have focused on the reorganization of peripheral nerve and spinal cord, but neural mechanisms of exactly what LBP impacts on the brain required further researches. Based on existing clinical studies that chronic pain problems were accompanying alterations in brain structures and functions, researchers proposed logical conjectures that similar alterations occur in LBP patients as well. With recent extensive studies carried out using noninvasive neuroimaging technique, increasing number of abnormalities and alterations has been identified. Here, we reviewed brain alterations including white matters, grey matters, and neural circuits between brain areas, which are involved in chronic LBP. Moreover, brain structural and functional connectivity abnormalities are correlated to the happening and transition of LBP. The negative emotions related to back pain indicate possible alterations in emotional brain regions. Thus, the aim of this review is to summarize current findings on the alterations corresponding to LBP in the brain. It will not only further our understanding of etiology of LBP and understanding of negative emotions accompanying with back pain but also provide ideas and basis for new accesses to the diagnosis, treatment, and rehabilitation afterward based on integral medicine.
下背痛（LBP）是全球残疾的主要原因。众多分子、细胞和解剖因素与 LBP 有关。目前关于 LBP 神经改变的问题集中在外周神经和脊髓的重组，但 LBP 究竟影响大脑的神经机制需要进一步研究。基于现有的临床研究，慢性疼痛问题伴随着大脑结构和功能的改变，研究人员提出了合理的假设，即类似的改变也发生在 LBP 患者中。随着最近使用非侵入性神经影像学技术进行的广泛研究，越来越多的异常和改变已经被确定。在这里，我们回顾了与慢性 LBP 相关的大脑改变，包括白质、灰质和脑区之间的神经回路。此外，大脑结构和功能连接的异常与 LBP 的发生和转变有关。与背部疼痛相关的负面情绪表明情绪脑区可能发生了改变。因此，本综述的目的是总结目前关于大脑中与 LBP 相对应的改变的发现。它不仅将进一步加深我们对 LBP 病因的理解，对伴随背部疼痛的负面情绪的理解，而且为基于整体医学的诊断、治疗和康复的新方法提供思路和基础。
