A multisite validation of brain white matter pathways of resilience to chronic back pain

Chronic back pain (CBP) is a global health concern with significant societal and economic burden. While various predictors of back pain chronicity have been proposed, including demographic and psychosocial factors, neuroimaging studies have pointed to brain characteristics as predictors of CBP. Howe...

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Main Authors: Mina Mišić, Noah Lee, Francesca Zidda, Kyungjin Sohn, Katrin Usai, Martin Löffler, Md Nasir Uddin, Arsalan Farooqi, Giovanni Schifitto, Zhengwu Zhang, Frauke Nees, Paul Geha, Herta Flor
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Language:English
Published: eLife Sciences Publications Ltd 2024-12-01
Series:eLife
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Online Access:https://elifesciences.org/articles/96312
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author Mina Mišić
Noah Lee
Francesca Zidda
Kyungjin Sohn
Katrin Usai
Martin Löffler
Md Nasir Uddin
Arsalan Farooqi
Giovanni Schifitto
Zhengwu Zhang
Frauke Nees
Paul Geha
Herta Flor
author_facet Mina Mišić
Noah Lee
Francesca Zidda
Kyungjin Sohn
Katrin Usai
Martin Löffler
Md Nasir Uddin
Arsalan Farooqi
Giovanni Schifitto
Zhengwu Zhang
Frauke Nees
Paul Geha
Herta Flor
author_sort Mina Mišić
collection DOAJ
description Chronic back pain (CBP) is a global health concern with significant societal and economic burden. While various predictors of back pain chronicity have been proposed, including demographic and psychosocial factors, neuroimaging studies have pointed to brain characteristics as predictors of CBP. However, large-scale, multisite validation of these predictors is currently lacking. In two independent longitudinal studies, we examined white matter diffusion imaging data and pain characteristics in patients with subacute back pain (SBP) over 6- and 12-month periods. Diffusion data from individuals with CBP and healthy controls (HC) were analyzed for comparison. Whole-brain tract-based spatial statistics analyses revealed that a cluster in the right superior longitudinal fasciculus (SLF) tract had larger fractional anisotropy (FA) values in patients who recovered (SBPr) compared to those with persistent pain (SBPp), and predicted changes in pain severity. The SLF FA values accurately classified patients at baseline and follow-up in a third publicly available dataset (Area under the Receiver Operating Curve ~0.70). Notably, patients who recovered had FA values larger than those of HC suggesting a potential role of SLF integrity in resilience to CBP. Structural connectivity-based models also classified SBPp and SBPr patients from the three data sets (validation accuracy 67%). Our results validate the right SLF as a robust predictor of CBP development, with potential for clinical translation. Cognitive and behavioral processes dependent on the right SLF, such as proprioception and visuospatial attention, should be analyzed in subacute stages as they could prove important for back pain chronicity.
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spelling doaj-art-baea59e8d87544f0857e2bf48091a4522025-08-20T02:40:30ZengeLife Sciences Publications LtdeLife2050-084X2024-12-011310.7554/eLife.96312A multisite validation of brain white matter pathways of resilience to chronic back painMina Mišić0https://orcid.org/0000-0003-1754-8681Noah Lee1Francesca Zidda2https://orcid.org/0000-0003-2507-0542Kyungjin Sohn3Katrin Usai4https://orcid.org/0000-0002-8534-3373Martin Löffler5Md Nasir Uddin6Arsalan Farooqi7Giovanni Schifitto8Zhengwu Zhang9https://orcid.org/0000-0002-9047-8838Frauke Nees10Paul Geha11https://orcid.org/0000-0002-0537-7216Herta Flor12Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyDepartment of Psychiatry, University of Rochester Medical Center, Rochester, United StatesInstitute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyDepartment of Statistics and Operations Research, University of North Carolina, Chapel Hill, Rochester, United StatesInstitute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyInstitute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, GermanyDepartment of Neurology, University of Rochester Medical Center, Rochester, United StatesDepartment of Psychiatry, University of Rochester Medical Center, Rochester, United StatesDepartment of Neurology, University of Rochester Medical Center, Rochester, United StatesDepartment of Statistics and Operations Research, University of North Carolina, Chapel Hill, Rochester, United StatesInstitute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, GermanyDepartment of Psychiatry, University of Rochester Medical Center, Rochester, United StatesInstitute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, GermanyChronic back pain (CBP) is a global health concern with significant societal and economic burden. While various predictors of back pain chronicity have been proposed, including demographic and psychosocial factors, neuroimaging studies have pointed to brain characteristics as predictors of CBP. However, large-scale, multisite validation of these predictors is currently lacking. In two independent longitudinal studies, we examined white matter diffusion imaging data and pain characteristics in patients with subacute back pain (SBP) over 6- and 12-month periods. Diffusion data from individuals with CBP and healthy controls (HC) were analyzed for comparison. Whole-brain tract-based spatial statistics analyses revealed that a cluster in the right superior longitudinal fasciculus (SLF) tract had larger fractional anisotropy (FA) values in patients who recovered (SBPr) compared to those with persistent pain (SBPp), and predicted changes in pain severity. The SLF FA values accurately classified patients at baseline and follow-up in a third publicly available dataset (Area under the Receiver Operating Curve ~0.70). Notably, patients who recovered had FA values larger than those of HC suggesting a potential role of SLF integrity in resilience to CBP. Structural connectivity-based models also classified SBPp and SBPr patients from the three data sets (validation accuracy 67%). Our results validate the right SLF as a robust predictor of CBP development, with potential for clinical translation. Cognitive and behavioral processes dependent on the right SLF, such as proprioception and visuospatial attention, should be analyzed in subacute stages as they could prove important for back pain chronicity.https://elifesciences.org/articles/96312chronic back painchronic pain developmentdiffusion tensor imagingsuperior longitudinal fasciculusfronto-parietal network
spellingShingle Mina Mišić
Noah Lee
Francesca Zidda
Kyungjin Sohn
Katrin Usai
Martin Löffler
Md Nasir Uddin
Arsalan Farooqi
Giovanni Schifitto
Zhengwu Zhang
Frauke Nees
Paul Geha
Herta Flor
A multisite validation of brain white matter pathways of resilience to chronic back pain
eLife
chronic back pain
chronic pain development
diffusion tensor imaging
superior longitudinal fasciculus
fronto-parietal network
title A multisite validation of brain white matter pathways of resilience to chronic back pain
title_full A multisite validation of brain white matter pathways of resilience to chronic back pain
title_fullStr A multisite validation of brain white matter pathways of resilience to chronic back pain
title_full_unstemmed A multisite validation of brain white matter pathways of resilience to chronic back pain
title_short A multisite validation of brain white matter pathways of resilience to chronic back pain
title_sort multisite validation of brain white matter pathways of resilience to chronic back pain
topic chronic back pain
chronic pain development
diffusion tensor imaging
superior longitudinal fasciculus
fronto-parietal network
url https://elifesciences.org/articles/96312
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