Comparison of brain structure between pain-susceptible and asymptomatic individuals following experimental induction of low back pain

Jeff Boissoneault, Charles W. Penza, Steven Z. George, Michael E. Robinson, Mark D. Bishop

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background Context: Peripheral differences often do not adequately account for variation in reports of pain intensity in people with musculoskeletal pain. Purpose: Here we sought to determine the extent to which structural differences in the brain (grey matter density) of pain free individuals might relate to subsequent pain (or lack thereof) after standardized peripheral muscle injury (ie, micro trauma from high intensity exercise). Study Design: This was an observational laboratory-based study that was a secondary analysis from a larger trial. Methods: Participants completed baseline testing (functional MRI and quantitative pain testing) followed by high intensity trunk exercise to induce delayed onset muscle soreness in the erector spinae. Forty-eight hours later, back pain intensity ratings were collected and all participants were re-imaged. Grey matter density was determined using voxel-based morphometry. The “asymptomatic” group (no reports of any pain within 48 hours after induction) to a ‘pain’ group (rating of pain at rest and movement pf>20 on a 101-point numeric rating scale). Results: Our results revealed several large clusters where, compared to participants with pain, asymptomatic participants had significant greater grey matter density. These brain regions included left medial frontal gyrus, left middle occipital gyrus, left middle temporal gyrus, left inferior frontal gyrus, and right superior frontal gyrus. Conclusions: Lower grey matter density in brain regions previously linked to discriminative, emotional, and cognitive aspects of cortical processing are associated with reporting musculoskeletal pain after a standardized peripheral muscle injury. Clinical Significance: Cortical gray matter density of people without any pain may influence response to a standardized high intensity exercise protocol. This finding adds further support to the relevance of central factors in explaining the tremendous individual variability in pain report following acute musculoskeletal injury.

Original languageEnglish (US)
Pages (from-to)292-299
Number of pages8
JournalSpine Journal
Volume20
Issue number2
DOIs
StatePublished - Feb 2020
Externally publishedYes

Bibliographical note

Funding Information:
We would like to acknowledge the participants who volunteered for this study and the work of the investigators on the primary trial – Maggie Horn, DPT, PhD, MPH; Meryl Alappattu, DPT, PhD, Joel Bialosky, PT, PhD; Fredy Solis, PT, PhD; Kara Hannibal, DPT; Warren Greenfield, MS; and Cally House, BS. This work was supported by the National Center of Complementary and Integrative Health (grant numbers: R01AT006334 , F32AT007729 ). A portion of this work was performed in the McKnight Brain Institute at the National High Magnetic Field Laboratory's AMRIS Facility, which is supported by National Science Foundation Cooperative Agreement No. DMR-1157490 , and the State of Florida.

Funding Information:
Author disclosures: JB: Nothing to disclose. CP: Nothing to disclose. SG: Grants: NIH-NIAMS (F); Royalties: Rehab Essentials (B); Scientific Advisory Board: NIH (A); Grants: NIH/PCORI (F). MR: Grant: NIH (F). MB: Grant: NIH-NCCIH (F); Consulting: Bona Vista Services, LLC (B); Speaking arrangements: Pain Summit (A); Grants: NIH-NIAMS (F).

Publisher Copyright:
© 2019 Elsevier Inc.

Keywords

  • Cortex
  • Grey matter
  • Imaging
  • Pain

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