Hypoconnectivity of the Amygdala in Patients with Low-Back-Related Leg Pain Linked to Individual Mechanical Pain Sensitivity: A Resting-State Functional MRI Study

Ziyun Wang; Yao Wang; Yuqi Ji; Ziwei Yang; Yixiu Pei; Jiankun Dai; Yong Zhang; Fuqing Zhou

doi:10.2147/JPR.S425874

Hypoconnectivity of the Amygdala in Patients with Low-Back-Related Leg Pain Linked to Individual Mechanical Pain Sensitivity: A Resting-State Functional MRI Study

J Pain Res. 2023 Nov 8:16:3775-3784. doi: 10.2147/JPR.S425874. eCollection 2023.

Authors

Ziyun Wang^#^{1

2}, Yao Wang^#^{1

2}, Yuqi Ji^{1

2}, Ziwei Yang^{1

2}, Yixiu Pei³, Jiankun Dai⁴, Yong Zhang⁵, Fuqing Zhou^{1

2}

Affiliations

¹ Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, 330006, People's Republic of China.
² Neuroradiology Laboratory, Jiangxi Province Medical Imaging Research Institute, Nanchang, 330006, People's Republic of China.
³ Department of Radiology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, People's Republic of China.
⁴ MR Advanced Application, GE Healthcare, Beijing, 100176, People's Republic of China.
⁵ Department of Pain Clinic, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, 330006, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: To explore resting-state functional connectivity (rsFC) of the amygdala in patients with low-back-related leg pain (LBLP).

Patients and methods: For this prospective study, a total of 35 LBLP patients and 30 healthy controls (HCs) were included and underwent functional MRI and clinical assessments. Then, patients with LBLP were divided into acute LBLP (aLBLP) and chronic LBLP (cLBLP) subgroups. We further evaluated the between-group rsFC differences using left and right amygdala seeds in a whole-brain voxel analysis strategy. Finally, we performed correlation analysis between the rsFC values of altered regions and clinical indices.

Results: Compared to HCs, hypoconnectivity of the amygdala was observed in LBLP patients (P < 0.01, with correction). The amygdala's rsFC pattern was different between aLBLP and cLBLP patients: decreased the amygdala's FC to the right putamen, to the right paracentral lobule (PCL), or to the right posterior temporal lobe in aLBLP patients, while right amygdala to the bilateral anterior cingulate cortex (ACC) and the left postcentral gyrus (PoCG) in cLBLP patients. Correlation analysis showed that lower rsFC of the left amygdala to the right PCL was correlated with the von Frey filament (vF) test values of the left lumbar (p = 0.025) and right lumbar (p = 0.019) regions, and rsFC of the right amygdala to the left PoCG was correlated with lower vF test values of the left lumbar (p = 0.017), right lumbar spine (p = 0.003); to right PoCG was correlated with calf (p = 0.015); the rsFC of the right amygdala to bilateral ACC was negatively correlated with the pain rating index (p = 0.003).

Conclusion: LBLP patients showed amygdala hypoconnectivity, and the altered pattern of amygdala rsFC was different in the acute and chronic phases. Moreover, the amygdala hypoconnectivity was related to individual mechanical sensitivity (vF test) in LBLP patients.

Keywords: acute pain; amygdala; chronic pain; low-back-related leg pain; resting-state functional MRI.