Chen Xingyao, Chen Nuo, Lai Peng, Sun Yiqi, Yu Jie, Xin Ming, Zhu Deliang, Liang Fanrong, Song Qian, Cheng Shirui, Li Zhengjie
The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Front Neurosci. 2025 Feb 5;19:1535288. doi: 10.3389/fnins.2025.1535288. eCollection 2025.
Neuroimaging investigations into chronic low back pain (CLBP) have detected functional abnormalities across a spectrum of brain regions, yet the findings have often been inconsistent. In this meta-analysis, we integrated the existing data, delineating a pattern of coherent results from the encompassed studies.
A systematic search of neuroimaging studies investigating the brain activity differences between CLBP and Healthy controls (HCs) was conducted in seven databases up to December 22, 2024. An anisotropic effect-size signed differential mapping (AES-SDM)-based meta-analysis was carried out to report the results and perform a multimodal analysis.
A total of 20 publications reporting on 24 experiments in this meta-analysis. The ReHo meta-analysis showed abnormal spontaneous activity of left inferior temporal gyrus (ITG), left superior frontal gyrus (SFG), right middle frontal gyrus (MFG), right precuneus, right fusiform gyrus and bilateral postcentral gyrus (PoCG) in CLBP patients. The ALFF meta-analysis demonstrated functional alterations in the right rolandic operculum (extending to the right insula and right IFG), left ITG, left middle occipital gyrus (MOG), left paracentral lobule, left PoCG and bilateral cuneus cortex in CLBP patients. The results of the functional group meta-analysis revealed that patients with CLBP displayed new decreased functional activity in the right thalamus, right precentral gyrus (PreCG) and right lingual gyrus.
Patients with CLBP exhibit extensive multimodal functional neuroimaging abnormalities, involving brain regions related to pain perception, emotional processing, cognitive functions, and both the visual and motor cortices. These meta-analysis findings might provide a valuable reference for the identification of potential therapeutic targets for CLBP in the brain.
对慢性下腰痛（CLBP）的神经影像学研究已在一系列脑区检测到功能异常，但研究结果往往不一致。在这项荟萃分析中，我们整合了现有数据，勾勒出纳入研究的连贯结果模式。
截至2024年12月22日，在七个数据库中对调查CLBP患者与健康对照（HCs）之间脑活动差异的神经影像学研究进行了系统检索。进行了基于各向异性效应大小符号差异映射（AES-SDM）的荟萃分析以报告结果并进行多模态分析。
本荟萃分析共有20篇出版物报告了24项实验。静息态局部一致性（ReHo）荟萃分析显示，CLBP患者左侧颞下回（ITG）、左侧额上回（SFG）、右侧额中回（MFG）、右侧楔前叶、右侧梭状回和双侧中央后回（PoCG）存在异常自发活动。低频振幅（ALFF）荟萃分析表明，CLBP患者右侧中央沟盖（延伸至右侧岛叶和右侧额下回）、左侧ITG、左侧枕中回（MOG）、左侧中央旁小叶、左侧PoCG和双侧楔叶皮质存在功能改变。功能组荟萃分析结果显示，CLBP患者右侧丘脑、右侧中央前回（PreCG）和右侧舌回出现新的功能活动降低。
CLBP患者表现出广泛的多模态功能神经影像学异常，涉及与疼痛感知、情绪处理、认知功能以及视觉和运动皮层相关脑区。这些荟萃分析结果可能为确定CLBP在大脑中的潜在治疗靶点提供有价值的参考。
