Significant differences of brain blood flow in patients with chronic low back pain and acute low back pain detected by brain SPECT

Yukio Nakamura, Kenya Nojiri, Hiroyuki Yoshihara, Takeshi Takahata, Kumiko Honda-Takahashi, Saori Kubo, Kazuyuki Sakatsume, Hiroyuki Kato, Toshihiko Maruta, Tetsumi Honda

    Research output: Contribution to journalArticle

    5 Citations (Scopus)

    Abstract

    Background: The aim of this study was to examine and compare the areas of brain blood flow in patients with chronic low back pain (CLBP) without structural abnormality and acute low back pain (ALBP) with lumber disc herniation (LDH). Functional neuroimaging studies provide evidence of abnormalities in the regional cerebral blood flow during low back pain. Recent studies have shown that CLBP is associated with plastic, pathophysiological changes in the brain. However, there has been no report yet statistically or by neuro-images on the compared brain single photon-emission computed tomography (SPECT) findings between CLBP and ALBP patients. Methods: The subjects comprised 14 patients, 7 CLBP and 7 ALBP patients. The CLBP group included the patients who had no or minor structural abnormality in the lumbar spine on magnetic resonance imaging (MRI) and met the criteria for a classification of "pain disorder" (chronic) according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. The ALBP group included the patients who had symptoms within 3 months of onset and LDH revealed by MRI. All patients were assessed using brain SPECT. We then performed a two-tailed view analysis using the easy Z score imaging system, determined the mean Z scores, and performed vBSEE software (Fujifilm RI Pharma, Tokyo, Japan) for both CLBP and ALBP patients. Results: The CLBP group showed significantly reduced blood flow in the bilateral prefrontal cortex of the frontal lobe and increased blood flow in the bilateral posterior lobe of the cerebellum. Conclusions: SPECT images and statistical analyses revealed the brain blood flow alterations in the patients with ALBP and CLBP. These results may suggest that the dysfunction of the prefrontal cortex could lead to the appearance of unconscious pain behavior controlled by the cerebellum in the patients with CLBP.

    Original languageEnglish
    Pages (from-to)384-389
    Number of pages6
    JournalJournal of Orthopaedic Science
    Volume19
    Issue number3
    DOIs
    Publication statusPublished - 2014

    Fingerprint

    Low Back Pain
    Single-Photon Emission-Computed Tomography
    Brain
    Prefrontal Cortex
    Cerebellum
    Cerebrovascular Circulation
    Magnetic Resonance Imaging
    Functional Neuroimaging
    Somatoform Disorders
    Tokyo
    Regional Blood Flow
    Frontal Lobe
    Diagnostic and Statistical Manual of Mental Disorders
    Plastics
    Japan

    ASJC Scopus subject areas

    • Orthopedics and Sports Medicine
    • Medicine(all)

    Cite this

    Significant differences of brain blood flow in patients with chronic low back pain and acute low back pain detected by brain SPECT. / Nakamura, Yukio; Nojiri, Kenya; Yoshihara, Hiroyuki; Takahata, Takeshi; Honda-Takahashi, Kumiko; Kubo, Saori; Sakatsume, Kazuyuki; Kato, Hiroyuki; Maruta, Toshihiko; Honda, Tetsumi.

    In: Journal of Orthopaedic Science, Vol. 19, No. 3, 2014, p. 384-389.

    Research output: Contribution to journalArticle

    Nakamura, Y, Nojiri, K, Yoshihara, H, Takahata, T, Honda-Takahashi, K, Kubo, S, Sakatsume, K, Kato, H, Maruta, T & Honda, T 2014, 'Significant differences of brain blood flow in patients with chronic low back pain and acute low back pain detected by brain SPECT', Journal of Orthopaedic Science, vol. 19, no. 3, pp. 384-389. https://doi.org/10.1007/s00776-014-0534-2
    Nakamura, Yukio ; Nojiri, Kenya ; Yoshihara, Hiroyuki ; Takahata, Takeshi ; Honda-Takahashi, Kumiko ; Kubo, Saori ; Sakatsume, Kazuyuki ; Kato, Hiroyuki ; Maruta, Toshihiko ; Honda, Tetsumi. / Significant differences of brain blood flow in patients with chronic low back pain and acute low back pain detected by brain SPECT. In: Journal of Orthopaedic Science. 2014 ; Vol. 19, No. 3. pp. 384-389.
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    abstract = "Background: The aim of this study was to examine and compare the areas of brain blood flow in patients with chronic low back pain (CLBP) without structural abnormality and acute low back pain (ALBP) with lumber disc herniation (LDH). Functional neuroimaging studies provide evidence of abnormalities in the regional cerebral blood flow during low back pain. Recent studies have shown that CLBP is associated with plastic, pathophysiological changes in the brain. However, there has been no report yet statistically or by neuro-images on the compared brain single photon-emission computed tomography (SPECT) findings between CLBP and ALBP patients. Methods: The subjects comprised 14 patients, 7 CLBP and 7 ALBP patients. The CLBP group included the patients who had no or minor structural abnormality in the lumbar spine on magnetic resonance imaging (MRI) and met the criteria for a classification of {"}pain disorder{"} (chronic) according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. The ALBP group included the patients who had symptoms within 3 months of onset and LDH revealed by MRI. All patients were assessed using brain SPECT. We then performed a two-tailed view analysis using the easy Z score imaging system, determined the mean Z scores, and performed vBSEE software (Fujifilm RI Pharma, Tokyo, Japan) for both CLBP and ALBP patients. Results: The CLBP group showed significantly reduced blood flow in the bilateral prefrontal cortex of the frontal lobe and increased blood flow in the bilateral posterior lobe of the cerebellum. Conclusions: SPECT images and statistical analyses revealed the brain blood flow alterations in the patients with ALBP and CLBP. These results may suggest that the dysfunction of the prefrontal cortex could lead to the appearance of unconscious pain behavior controlled by the cerebellum in the patients with CLBP.",
    author = "Yukio Nakamura and Kenya Nojiri and Hiroyuki Yoshihara and Takeshi Takahata and Kumiko Honda-Takahashi and Saori Kubo and Kazuyuki Sakatsume and Hiroyuki Kato and Toshihiko Maruta and Tetsumi Honda",
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    AU - Nakamura, Yukio

    AU - Nojiri, Kenya

    AU - Yoshihara, Hiroyuki

    AU - Takahata, Takeshi

    AU - Honda-Takahashi, Kumiko

    AU - Kubo, Saori

    AU - Sakatsume, Kazuyuki

    AU - Kato, Hiroyuki

    AU - Maruta, Toshihiko

    AU - Honda, Tetsumi

    PY - 2014

    Y1 - 2014

    N2 - Background: The aim of this study was to examine and compare the areas of brain blood flow in patients with chronic low back pain (CLBP) without structural abnormality and acute low back pain (ALBP) with lumber disc herniation (LDH). Functional neuroimaging studies provide evidence of abnormalities in the regional cerebral blood flow during low back pain. Recent studies have shown that CLBP is associated with plastic, pathophysiological changes in the brain. However, there has been no report yet statistically or by neuro-images on the compared brain single photon-emission computed tomography (SPECT) findings between CLBP and ALBP patients. Methods: The subjects comprised 14 patients, 7 CLBP and 7 ALBP patients. The CLBP group included the patients who had no or minor structural abnormality in the lumbar spine on magnetic resonance imaging (MRI) and met the criteria for a classification of "pain disorder" (chronic) according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. The ALBP group included the patients who had symptoms within 3 months of onset and LDH revealed by MRI. All patients were assessed using brain SPECT. We then performed a two-tailed view analysis using the easy Z score imaging system, determined the mean Z scores, and performed vBSEE software (Fujifilm RI Pharma, Tokyo, Japan) for both CLBP and ALBP patients. Results: The CLBP group showed significantly reduced blood flow in the bilateral prefrontal cortex of the frontal lobe and increased blood flow in the bilateral posterior lobe of the cerebellum. Conclusions: SPECT images and statistical analyses revealed the brain blood flow alterations in the patients with ALBP and CLBP. These results may suggest that the dysfunction of the prefrontal cortex could lead to the appearance of unconscious pain behavior controlled by the cerebellum in the patients with CLBP.

    AB - Background: The aim of this study was to examine and compare the areas of brain blood flow in patients with chronic low back pain (CLBP) without structural abnormality and acute low back pain (ALBP) with lumber disc herniation (LDH). Functional neuroimaging studies provide evidence of abnormalities in the regional cerebral blood flow during low back pain. Recent studies have shown that CLBP is associated with plastic, pathophysiological changes in the brain. However, there has been no report yet statistically or by neuro-images on the compared brain single photon-emission computed tomography (SPECT) findings between CLBP and ALBP patients. Methods: The subjects comprised 14 patients, 7 CLBP and 7 ALBP patients. The CLBP group included the patients who had no or minor structural abnormality in the lumbar spine on magnetic resonance imaging (MRI) and met the criteria for a classification of "pain disorder" (chronic) according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. The ALBP group included the patients who had symptoms within 3 months of onset and LDH revealed by MRI. All patients were assessed using brain SPECT. We then performed a two-tailed view analysis using the easy Z score imaging system, determined the mean Z scores, and performed vBSEE software (Fujifilm RI Pharma, Tokyo, Japan) for both CLBP and ALBP patients. Results: The CLBP group showed significantly reduced blood flow in the bilateral prefrontal cortex of the frontal lobe and increased blood flow in the bilateral posterior lobe of the cerebellum. Conclusions: SPECT images and statistical analyses revealed the brain blood flow alterations in the patients with ALBP and CLBP. These results may suggest that the dysfunction of the prefrontal cortex could lead to the appearance of unconscious pain behavior controlled by the cerebellum in the patients with CLBP.

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    U2 - 10.1007/s00776-014-0534-2

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