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Decreased activation of cingulo-frontal-parietal cognitive/attention network during an attention-demanding task in patients with chronic low back pain

  • Functional Neuroradiology
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Abstract

Introduction

Attention deficits have been repeatedly reported via neuropsychological assessment in previous literature in patients with chronic low back pain (CLBP). However, there are few functional neuroimaging studies of patients with CLBP during attention processing, and the exact underlying neural mechanisms are yet to be elucidated.

Methods

We used functional magnetic resonance imaging (fMRI) to measure the function of the cingulo-frontal-parietal (CFP) cognitive/attention network while performing a multi-source interference task (MSIT) in patients with CLBP. Thirty-six patients with CLBP and 36 healthy controls were included in this study. The fMRI data were analyzed with the FSL-FEAT software.

Results

Our results indicated that patients with CLBP showed significantly less activation in the CFP network including the right dorsolateral prefrontal cortex, the dorsal anterior cingulate cortex, and bilateral superior parietal cortex during attention-demanding (MSITinterference > MSITcontrol) trials compared to the healthy controls. A significant negative correlation was found between the scores of the visual analog scale for pain and activation of the right prefrontal cortex during performing the MSIT in patients with CLBP.

Conclusion

Our study provides in vivo imaging evidence of abnormal CFP network function during attention-demanding condition in patients with CLBP, which might reflect partly an adaptation/maladaptation of the brain to the chronic pain states.

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Ethical standards and patient consent

We declare that all human studies have been approved by the Research Ethics Committee of the First Affiliated Hospital of Xi’An Jiao Tong University College of Medicine and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients have given informed consent prior to inclusion in this study.

Acknowledgments

This work was supported partially by two grants from the National Natural Science Foundation of China, No. 30870686 and 81371530.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Medical Imaging, First Affiliated Hospital of Xi’An Jiao Tong University College of Medicine, 277#, West YantaRoad, Xi’an, Shaan’Xi, 710061, People’s Republic of China

    Cui Ping Mao, Qiu Li Zhang, Fa Xiu Bao & Ming Zhang

  2. Department of Pain, First Affiliated Hospital of Xi’An Jiao Tong University College of Medicine, Xi’an, Shaan’Xi, 710061, People’s Republic of China

    Xia Liao & Xiao Li Yang

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  1. Cui Ping Mao
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Correspondence to Ming Zhang.

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Supplementary Fig. 1

Correlation between VAS scores and BOLD responses of the right PFC in patients with CLBP. A significant negative correlation was found between the BOLD responses of the right PFC and scores of VAS. (TIFF 2265 kb)

Supplementary Fig. 2

BOLD responses of the brain during performing MIST (MSITinterference > MSITcontrol) in the two groups (first-level individual analysis). The upper row was for healthy controls and below for patients with CLBP. (TIFF 2323 kb)

Supplementary Fig. 3

CFP network activation of the 24 patients with CLBP untreated by NSAIDs/opiates while performing MSIT compared to the 36 healthy controls. Decreased activation was seen including the dorsal ACC (dACC), the bilateral superior parietal cortices and the right-sided PFC (P < 0.05, corrected), after adjusting for age, gender and education. R, right. (TIFF 1900 kb)

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Mao, C.P., Zhang, Q.L., Bao, F.X. et al. Decreased activation of cingulo-frontal-parietal cognitive/attention network during an attention-demanding task in patients with chronic low back pain. Neuroradiology 56, 903–912 (2014). https://doi.org/10.1007/s00234-014-1391-6

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  • DOI: https://doi.org/10.1007/s00234-014-1391-6

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