Are Functional Brain Alterations Present in Low Back Pain? A Systematic Review of EEG Studies

Stijn Schouppe; Sophie Van Oosterwijck; Lieven Danneels; Stefaan Van Damme; Jessica Van Oosterwijck

doi:10.1016/j.jpain.2019.06.010

Are Functional Brain Alterations Present in Low Back Pain? A Systematic Review of EEG Studies

J Pain. 2020 Jan-Feb;21(1-2):25-43. doi: 10.1016/j.jpain.2019.06.010. Epub 2019 Jun 28.

Authors

Stijn Schouppe¹, Sophie Van Oosterwijck², Lieven Danneels³, Stefaan Van Damme⁴, Jessica Van Oosterwijck⁵

Affiliations

¹ SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Pain in Motion International Research Group, Belgium, www.paininmotion.be.
² SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
³ SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium. Electronic address: lieven.danneels@ugent.be.
⁴ Department of Experimental - Clinical and Health Psychology, Ghent University, Ghent, Belgium.
⁵ SPINE Research Unit Ghent, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Pain in Motion International Research Group, Belgium, www.paininmotion.be; Research Foundation - Flanders (FWO), Brussels, Belgium.

PMID: 31260806
DOI: 10.1016/j.jpain.2019.06.010

Abstract

This systematic review analyzed available literature on functional brain alterations in low back pain (LBP) measured with electroencephalography (EEG), as until now evidence thereof was unclear. Four electronic databases were systematically searched the 10th of March 2018, resulting in 12 included studies. Studies showed a risk of bias of 37.5 to 75% using the Newcastle-Ottawa Scale for case-control studies. Limited evidence reported higher amplitudes of balance-related potentials and early components of somatosensory evoked potentials (SEP) to noxious stimuli, and altered feedback-related negativity and P300 potentials during decision-making in chronic LBP (CLBP). These findings suggest postural strategies requiring a higher cortical attention-demand, increased sensory-discriminative processing of noxious input, and altered decision-making in CLBP. However, further research is warranted as these inferences were based on single studies. Moderate evidence for unaltered amplitude of late-phase SEPs to noxious stimuli and auditory evoked potentials in LBP implies that the affective-emotional processing of stimuli might be unaffected in LBP. Furthermore, moderate evidence indicated disturbed habituation of somatosensory stimuli in LBP. Most studies examined nonspecific or mixed CLBP populations, hence EEG-quantified brain activity in (sub)acute or recurrent LBP still needs to be explored. PERSPECTIVE: This review presents an overview of the current understanding of the functional LBP brain measured with EEG. The limited evidence in current research suggests altered cortical function regarding balance control, somatosensory processing, and decision making in LBP, and highlights opportunities for future EEG-research.

Keywords: Central nervous system; Electroencephalography; Evoked potential; Low back pain.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Cerebral Cortex / physiopathology*
Chronic Pain / physiopathology*
Decision Making / physiology*
Electroencephalography*
Evoked Potentials / physiology*
Habituation, Psychophysiologic / physiology*
Humans
Low Back Pain / physiopathology*
Postural Balance / physiology*