title: Functional magnetic resonance imaging evaluation of lumbosacral radiculopathic pain.
abstract: OBJECTIVE An objective biomarker for pain is yet to be established. Functional MRI (fMRI) is a promising neuroimaging technique that may reveal an objective radiological biomarker. The purpose of this study was to evaluate fMRI technology in the setting of lumbosacral radiculopathy and discuss its application in revealing a biomarker for pain in the future. METHODS A prospective, within-participant control study was conducted. Twenty participants with painful lumbosacral radiculopathy from intervertebral disc pathology were recruited. Functional imaging of the brain was performed during a randomly generated series of nonprovocative and provocative straight leg raise maneuvers. RESULTS With a statistical threshold set at p < 0.000001, 3 areas showed significant blood oxygen level-dependent (BOLD) signal change: right superior frontal gyrus (x = 2, y = 13, z = 48, k = 29, Brodmann area 6 [BA6]), left supramarginal cortex (x = -37, y = -44, z = 33, k = 1084, BA40), and left parietal cortex (x = -19, y = -41, z = 63, k = 354, BA5). With a statistical threshold set at p < 0.0002, 2 structures showed significant BOLD signal change: right putamen (x = 29, y = -11, z = 6, k = 72) and bilateral thalami (right: x = 23, y = -11, z = 21, k = 29; x = 8, y = -11, z = 9, k = 274; and left: x = -28, y = -32, z = 6, k = 21). CONCLUSIONS The results in this study compare with those in previous studies and suggest that fMRI technology can provide an objective assessment of the pain experience.
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Koefman
authors.affiliation: Schools of 2 Sport Science, Exercise & Health and.
authors.forename: Melissa
authors.initials: M
authors.lastname: Licari
authors.affiliation: Neuroradiology, Sir Charles Gairdner Hospital; and.
authors.forename: Michael
authors.initials: M
authors.lastname: Bynevelt
authors.affiliation: Departments of 1 Neurosurgery and.|Surgery, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Christopher R P
authors.initials: CR
authors.lastname: Lind
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D007866:Leg / Q000503:physiopathology; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: ACC = anterior cingulate cortex; BA = Brodmann area; BOLD = blood oxygen level–dependent; LSR = lumbosacral radiculopathy; ODI = Oswestry Disability Index; PFC = prefrontal cortex; S1 = primary somatosensory cortex; S2 = secondary somatosensory cortex; SLR = straight leg raise; VAS = visual analog scale; fMRI = functional MRI; functional MRI; mPFC = medial PFC; pain; radiculopathy, technique