FUNCTIONAL MRI EVALUATION OF CENTRAL SENSITIZATION IN CHRONIC LOW BACK PAIN

Abstract

Chronic low back pain (CLBP) is a complex and disabling condition often underpinned by central sensitisation—a state of heightened central nervous system excitability that amplifies pain perception. This study aimed to investigate the neurophysiological and structural brain alterations associated with central sensitisation in individuals with CLBP using resting-state functional magnetic resonance imaging (fMRI) and clinical assessment tools. Apart from analyzing brain activity using fMRI, the study involved 60 patients (40 with CLBP and 20 healthy individuals) who completed the VAS, PCS and CSI questionnaires.  The information revealed that patients experiencing CLBP scored much higher on VAS, PCS and CSI scores.  Decreased functional connection was found between the prefrontal cortex (PFC) and thalamus, whereas functional connection increased within the ACC and insula.  Many nerve changes observed in the brain were linked not only to the condition itself but also to the signs of central sensitisation.  Chronic low back pain was linked by MRI to lower levels of grey matter in areas related to sensation and thinking.  Unusual differences in the connectivity of the brain were confirmed by analyzing Z-score deviation.  This demonstrates that fMRI can literally pick out the brain areas linked to persistent pain and with central sensitisation in mind.  It offers a solid background for comprehending chronic pain and guiding the development of individual, non-pharmacological care by combining reviews of brain images and clinical investigations.  The evidence from this work proves that neuroimaging biomarkers play a role in managing spinal pain and suggests that changes in the central nervous system are significant in CLBP.