康复学报 (Aug 2023)
Resting-State Functional Magnetic Resonance Imaging Study on the Functional Connectivity of Amygdalar Subregions in Patients with Chronic Non-Specific Low Back Pain
Abstract
ObjectiveTo observe the resting-state functional connectivity changes of amygdalar subregions as well as relationship with pain intensity and negative emotion states in patients with chronic non-specific low back pain (CNLBP).MethodsA total of 31 patients with CNLBP (CNLBP group) and 31 healthy control population (healthy control group) with age and gender matched were recruited in the community around Pingshan campus of Fujian University of Traditional Chinese Medicine to perform clinical evaluation and resting-state functional magnetic resonance imaging. Pain visual analog scale (VAS) was used to evaluate pain intensity; Beck depression inventory-Ⅱ (BDI-Ⅱ), Beck anxiety inventory (BAI) and fear avoidance beliefs questionnaires (FABQ) were used to evaluate the negative emotion states; Brain imaging data was preprocessed by using CONN 20.b toolbox, three subregions of bilateral amygdala [centromedial (CM), laterobasal (LB) and superficial (SF) areas] were chosen as the regions of interest via using SPM Anatomy 2.2b toolbox, and whole brain functional connectivity was calculated for each subject. The correlations between functional connectivity values of brain regions with significant differences in the CNLBP group and clinical evaluation results were also analyzed.ResultsCompared with the healthy control group, the scores of BDI-Ⅱ and BAI in CNLBP group were observably higher, and the difference was statistically significant (P<0.001). Compared with the healthy control group, functional connectivity between the left CM amygdala and right inferior occipital gyrus, between the left SF amygdala and left anterior cingulate cortex, right calcarine fissure & surrounding cortex and left thalamus in the CNLBP group significantly increased (P<0.05), but functional connectivity between the left LB amygdala and right angular gyrus, between the right SF amygdala and right hippocampus significantly decreased (P<0.05). Correlation analysis demonstrated that functional connectivity of the left SF amygdala and left anterior cingulate cortex was significantly positively correlated with the score of BDI-Ⅱ in the CNLBP groups (P<0.05), and the functional connectivity of the right SF amygdala and right hippocampus was significantly negatively correlated with VAS score (P<0.05).ConclusionFunctional con-nectivity of the left amygdalar subregion was mostly abnormal, reflecting the lateralization in patients with CNLBP; Altered resting-state functional connectivity of SF amygdala had significant correlation with pain intensity and depressive emotion of CNLBP patients. Amygdalar subregion may play an important role in CNLBP neuropathological mechanisms.
