Neurobiological substrates of chronic low back pain (CLBP): a brain [99mTc]Tc-ECD SPECT study

• Published in: European journal of hybrid imaging 2022-11, Vol.6 (1), p.26-10, Article 26
• Main Authors: Lia, Erica Negrini, Papassidero, Priscila Colavite, Coelho, Eduardo Barbosa, Dach, Fabíola, Alexandre-Santos, Leonardo, Trevisan, Ana Carolina, Santos, Lucas Emmanuel Lopes e, Silvah, Jose Henrique, Lanchote, Vera Lúcia, Pasqua, Oscar Della, Wichert-Ana, Lauro
• Format: Article
• Language: English
• Subjects: Back pain; Brain; Brain mapping; Brain SPECT; Chronic low back pain; Clusters; Cortex (cingulate); Cortex (frontal); Douleur Neuropathique 4 Questions; Imaging; Intervertebral discs; Low back pain; Medical imaging; Medicine; Medicine & Public Health; Neuralgia; Neurobiological substrate; Neurobiology; Neuroimaging; Neuroplasticity; Nuclear Medicine; Numeric rating scale; Occipital lobe; Original; Original Article; Pain; Parietal lobe; Pharmacodynamics; Pharmacokinetics; Pharmacology; Radiology; Single photon emission computed tomography; Substrates
• ISSN: 2510-3636; 2510-3636
• DOI: 10.1186/s41824-022-00145-2

Background Recent neuroimaging studies have demonstrated pathological mechanisms related to cerebral neuroplasticity in chronic low back pain (CLBP). Few studies have compared cerebral changes between patients with and without pain in the absence of an experimentally induced stimulus. We investigated the neurobiological substrates associated with chronic low back pain using [ 99m Tc]Tc-ECD brain SPECT and correlated rCBF findings with the numeric rating scale (NRS) of pain and douleur neuropathique en 4 questions (DN4). Ten healthy control volunteers and fourteen patients with neuropathic CLBP due to lumbar disc herniation underwent cerebral SPECT scans. A quantitative comparison of rCBF findings between patients and controls was made using the Statistical Parametric Mapping (SPM), revealing clusters of voxels with a significant increase or decrease in rCBF. The intensity of CLBP was assessed by NRS and by DN4. RESULTS: The results demonstrated an rCBF increase in clusters A (occipital and posterior cingulate cortex) and B (right frontal) and a decrease in cluster C (superior parietal lobe and middle cingulate cortex). NRS scores were inversely and moderately correlated with the intensity of rCBF increase in cluster B, but not to rCBF changes in clusters A and C. DN4 scores did not correlate with rCBF changes in all three clusters. CONCLUSIONS: This study will be important for future therapeutic studies that aim to validate the association of rCBF findings with the pharmacokinetic and pharmacodynamic profiles of therapeutic challenges in pain.