Relationship Between Attention Bias and Psychological Index in Individuals With Chronic Low Back Pain: A Preliminary Event-Related Potential Study.

Takayuki Tabira,Michio Maruta,Hiroki Takahashi,Takashi Matsuo,Takashi Hasegawa,Jun Tayama,Akira Sagari,Ko Matsudaira,Gwanghee Han

doi:10.3389/fnhum.2020.561726

Abstract

Introduction: Attention bias towards pain-related information exists in patients with chronic pain, and recently, attention bias modification (ABM) training has been administered to patients with chronic pain. In this study, we conducted an attention bias modification task in conjunction with event-related potential measurements for individuals with chronic low back pain (LBP) and investigated the relationship between attention bias and psychological assessment.Methods: Eleven women and two men with chronic LBP participated in the study.Results: The Japanese version of the STarT Back Screening Tool (J-SBST) total score was significantly correlated with the N1 amplitude of Cz. The J-SBST psychological score was significantly correlated with the N1 amplitude of Cz and with reaction time (RT). The Japanese version of the Pain Catastrophizing Scale (PCS) and Japanese version of the Beck Depression Inventory-Second Edition (BDI-II) scores were significantly correlated with the P2 amplitude at Fz (only PCS), Cz, and Pz.Conclusions: Our findings suggest that J-SBST, which provides a comprehensive evaluation of psychological factors, PCN with measuring of catastrophizing in the context of actual or anticipated pain, and BDI-II, can likely help identify chronic LBP patients with attention bias. For chronic LBP patients who are classified according to J-SBST or PCN pain-related outcome improvement with ABM training can be expected.

Highlights

Attention bias towards pain-related information exists in patients with chronic pain, and recently, attention bias modification (ABM) training has been administered to patients with chronic pain
This study aimed to clarify the relationship between attention bias and psychological assessments of individuals with chronic low back pain (LBP), we examined the attentional component of the event-related potentials (ERPs) as well as the Reaction time (RT) in the ABM to determine whether patients with chronic LBP who have higher socio-psychological factors such as fear-avoidance, catastrophizing and depression show more attentional bias to threat stimuli, this study can provide psychophysiological insight into how the psychological domains and its severity in individuals with chronic LBP relate to attention bias using ERP as well as RT
Our results showed that higher Japanese version of the SBST (J-SBST) total and psychological scores were associated with larger N1 amplitudes of Cz, and higher Pain Catastrophizing Scale (PCS) was associated with larger P2 amplitudes of Fz, Cz, and Pz

Summary

Introduction

Attention bias towards pain-related information exists in patients with chronic pain, and recently, attention bias modification (ABM) training has been administered to patients with chronic pain. We conducted an attention bias modification task in conjunction with event-related potential measurements for individuals with chronic low back pain (LBP) and investigated the relationship between attention bias and psychological assessment. The role of attention processing in chronic pain is important (Pincus and Morley, 2001), and many studies have investigated the existence of attention bias towards pain-related stimuli. A meta-analysis investigating attention bias to pain-related information indicates that attention bias towards pain-related words or pictures exists in people with chronic pain (Schoth et al, 2012; Crombez et al, 2013). Psychological factors, including fear-avoidance beliefs or somatizing tendency, had a significant association with chronic low back pain (LBP) among care workers (Yoshimoto et al, 2019). The Subgrouping for Targeted Treatment Back (STarT Back) Screening Tool (SBST) to assess and stratify patients with LBP according to the risk of LBP chronicity as psychological factors has been globally used and indicated that stratification of risk groups by the Japanese version of the SBST (J-SBST) may help predict prognosis of LBP (Matsudaira et al, 2016, 2017)

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