The following is a summary of “Disrupted Resting-State Functional Connectivity and Effective Connectivity of the Nucleus Accumbens in Chronic Low Back Pain: A Cross-Sectional Study,” published in the June 2024 issue of Pain by Zhang, et al.
Patients with chronic low back pain (cLBP) often experience emotional and cognitive issues, potentially linked to the nucleus accumbens (NAc) involved in mood, cognition, and pain perception.
Researchers conducted a retrospective study to explore how brain connections within the NAc and its subregions differ in patients with cLBP compared to HCs.
They conducted resting-state functional magnetic resonance imaging (rs-fMRI) on 34 patients with cLBP and 34 age- and sex-matched HC. The study utilized seed-based resting-state functional connectivity (rsFC) and Dynamic Causal Modelling (DCM) to analyze changes in resting-state functional connectivity (rsFC) and effective connectivity (EC) of the NAc.
The results showed that patients with cLBP had increased rsFC between the bilateral NAc and several brain regions, including the left superior frontal cortex (SFC), orbital frontal cortex (OFC), and left angular gyrus, as well as decreased rsFC with the left supramarginal gyrus, right precentral gyrus, left cerebellum, brainstem (medulla oblongata), and right insula compared to HC. The findings were consistent across NAc subregions. Additionally, rsFC between the left NAc and left SFC negatively correlated with Hamilton’s Depression Scale (HAMD) scores (r = -0.402, P=0.018), while rsFC between the left NAc and OFC positively correlated with present pain intensity scores (r = 0.406, P=0.017) in the cLBP group. The DCM revealed significantly increased EC from the left cerebellum to the right NAc in patients with cLBP compared to HC (P=0.012).
Investigators identified disrupted communication patterns within the NAc and emotional/cognitive processing regions in patients with cLBP, highlighting the potential importance of these factors in the condition.
