Key result
Lumbar disc herniation was associated with increased temporal coupling between the thalamus and dorsolateral prefrontal cortex, mediating the relationship from chronic pain to depression.
Why the study?
Mechanisms of thalamic pathways for chronic pain and psychological effects in chronic low back pain caused by lumbar disc herniation were not well understood.
Case-Control (n=74)
Thalamic pathways to the prefrontal cortex play a key role in regulating chronic pain and depression in patients with lumbar disc herniation.
Thalamo-prefrontal dysconnectivity may mediate pain-depression links in LDH; hypothesis-generating and requires longitudinal confirmation before clinical use.
Numerous neuroimaging studies have demonstrated that the brain plasticity is associated with chronic low back pain (cLBP). However, there is a lack of knowledge regarding the underlying mechanisms of thalamic pathways for chronic pain and psychological effects in cLBP caused by lumbar disc herniation (LDH). Combining psychophysics and magnetic resonance imaging (MRI), we investigated the structural and functional brain plasticity in 36 patients with LDH compared with 38 age- and gender-matched healthy controls. We found that (1) LDH patients had increased psychophysical disturbs (i.e., depression and anxiety), and depression (Beck-Depression Inventory, BDI) was found to be an outstanding significant factor to predict chronic pain (short form of the McGill Pain Questionnaire, SF-MPQ); (2) the LDH group showed significantly smaller fractional anisotropy values in the region of posterior corona radiate while gray matter volumes were comparable in both groups; (3) resting state functional connectivity analysis revealed that LDH patients exhibited increased temporal coupling between the thalamus and dorsolateral prefrontal cortex (DLPFC), which further mediate the relationship from chronic pain to depression. Our results emphasized that thalamic pathways underlying prefrontal cortex might play a key role in regulating chronic pain and depression of the pathophysiology of LDH.
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Li et al. (2021) conducted a case-control in Chronic low back pain caused by lumbar disc herniation (n=74). Lumbar disc herniation vs. Healthy controls was evaluated on Structural and functional brain plasticity and psychophysical disturbances. Lumbar disc herniation was associated with increased temporal coupling between the thalamus and dorsolateral prefrontal cortex, mediating the relationship from chronic pain to depression.
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