Abstract
Chronic back pain (CBP) is a leading cause of disability and results in considerable socio-economic burdens worldwide. Although CBP patients are commonly diagnosed and treated with a focus on the “end organ dysfunction” (i.e., peripheral nerve injuries or diseases), the evaluation of CBP remains flawed and problematic with great challenges. Given that the peripheral nerve injuries or diseases are insufficient to define the etiology of CBP in some cases, the evaluation of alterations in the central nervous system becomes particularly necessary and important. With the development of advanced neuroimaging techniques, extensive studies have been carried out to identify the cortical abnormalities in CBP patients. Here, we provide a comprehensive overview on a series of novel findings from these neuroimaging studies to improve our understanding of the cortical abnormalities originated in the disease. First, CBP patients normally exhibit central sensitization to external painful stimuli, which is indexed by increased pain sensitivity and brain activations in pain-related brain regions. Second, long-term suffering from chronic pain leads to emotional disorders, cognitive impairments, and the abnormalities of the relevant brain networks among CBP patients. Third, CBP is associated with massive cortical reorganization, including structural, functional, and metabolic brain changes. Overall, a deep insight into the neural mechanisms underlying the development and outcome of CBP through more sophisticated neuroimaging investigations could not only improve our current understanding of the etiology of CBP but also facilitate the diagnosis and treatment of CBP based on precision medicine.
Highlights
As a substantial worldwide health problem, chronic back pain (CBP) is one of the most frequent complaints and the second most common symptom reported by patients during their primary physical care visits (Mantyselka et al, 2001; Vogt et al, 2005)
The structural magnetic resonance imaging (MRI) could provide anatomical information of the brain with high spatial resolution, and the functional MRI is used to determine the location of the “activate” brain regions during cognitive tasks (Aine, 1995; Lindquist, 2008; Huettel et al, 2009; Sadek, 2012). Both techniques are helpful to provide information about brain organization and offer potential new criteria for assessing the neurological status and neurosurgical risk; they are widely employed to characterize structural or functional brain alterations among Chronic back pain (CBP) patients under clinical settings (Wand et al, 2011; Ng et al, 2018). Since these neuroimaging techniques have distinct advantages, we reviewed studies that explore the cortical abnormalities in CBP patients using structural MRI, resting state fMRI, and task fMRI, respectively
With the development of non-invasive neuroimaging techniques, a series of novel findings were obtained in this field
Summary
As a substantial worldwide health problem, chronic back pain (CBP) is one of the most frequent complaints and the second most common symptom reported by patients during their primary physical care visits (Mantyselka et al, 2001; Vogt et al, 2005). The structural MRI could provide anatomical information of the brain with high spatial resolution, and the functional MRI (fMRI) is used to determine the location of the “activate” brain regions during cognitive tasks (Aine, 1995; Lindquist, 2008; Huettel et al, 2009; Sadek, 2012) Both techniques are helpful to provide information about brain organization and offer potential new criteria for assessing the neurological status and neurosurgical risk; they are widely employed to characterize structural or functional brain alterations among CBP patients under clinical settings (Wand et al, 2011; Ng et al, 2018). Several studies have reported that the GM density of CBP patients was significantly reduced in a series of pain-related brain regions, including the dorsolateral prefrontal
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
