Differences in brain structure and function in older adults with self-reported disabling and nondisabling chronic low back pain.
OBJECTIVE
The primary aim of this pilot study was to identify structural and functional brain differences in older adults with self-reported disabling chronic low back pain (CLBP) compared with those who reported nondisabling CLBP.


METHODS
Cross-sectional.


METHODS
Sixteen cognitively intact older adults, eight with disabling CLBP and eight with nondisabling CLBP. Exclusions were psychiatric or neurological disorders, substance abuse, opioid use, or diabetes mellitus.


METHODS
Participants underwent: structural and functional brain MRI; neuropsychological assessment using the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Tests A and B; and physical performance assessment using the Short Physical Performance Battery.


RESULTS
In the disabled group, there was significantly lower white matter (WM) integrity (P < 0.05) of the splenium of the corpus callosum. This group also demonstrated activation of the right medial prefrontal cortex at rest whereas the nondisabled demonstrated activation of the left lateral prefrontal cortex. Combined groups analysis revealed a strong positive correlation (r(s) = 0.80, P < 0.0002) between WM integrity of the left centrum semiovale with gait-speed. Secondary analysis revealed a strong negative correlation between total months of CLBP and WM integrity of the SCC (r(s) = -0.59, P < 0.02).


CONCLUSIONS
Brain structure and function is different in older adults with disabling CLBP compared with those with nondisabling CLBP. Deficits in brain morphology combining groups are associated with pain duration and poor physical function. Our findings suggest brain structure and function may play a key role in chronic pain related disability and may be important treatment targets.
Buckalew
Neilly
N
Clinical Scientist Training Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. neilly.buckalew@gmail.com
Haut
Marc W
MW
Aizenstein
Howard
H
Morrow
Lisa
L
Perera
Subashan
S
Kuwabara
Hiroto
H
Weiner
Debra K
DK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000033:anatomy & histology / Q000503:physiopathology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D010147:Pain Measurement; D010865:Pilot Projects