TY - JOUR
T1 - Cortical function and sensorimotor plasticity are prognostic factors associated with future low back pain after an acute episode
T2 - the Understanding persistent Pain Where it ResiDes prospective cohort study
AU - Jenkins, Luke C
AU - Chang, Wei-Ju
AU - Buscemi, Valentina
AU - Liston, Matthew
AU - Humburg, Peter
AU - Nicholas, Michael
AU - Graven-Nielsen, Thomas
AU - Hodges, Paul W
AU - McAuley, James H
AU - Schabrun, Siobhan M
N1 - Copyright © 2022 International Association for the Study of Pain.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Predicting the development of chronic low back pain (LBP) at the time of an acute episode remains challenging. The Understanding persistent Pain Where it ResiDes study aimed to identify neurobiological and psychological risk factors for chronic LBP. Individuals with acute LBP (N = 120) participated in a prospective cohort study with 6-month follow-up. Candidate predictors were selected from the neurobiological (eg, sensorimotor cortical excitability assessed by sensory and motor-evoked potentials and brain-derived neurotrophic factor genotype), psychological (eg, depression and anxiety), symptom-related (eg, LBP history), and demographic domains. Analyses involved multivariable linear regression models with pain intensity or disability degree as continuous variables. Secondary analyses involved a multivariable logistic model with the presence of LBP at 6 months (thresholding pain intensity and disability degree) as a dichotomous variable. Lower sensory cortex and corticomotor excitability, higher baseline pain intensity, higher depression, stress, and pain catastrophizing were the strongest predictors ( R2 = 0.47) of pain intensity at 6 months. Older age and higher pain catastrophizing were the strongest predictors ( R2 = 0.30) of disability at 6 months. When the LBP outcome was dichotomised, sensory cortex and corticomotor excitability, brain-derived neurotrophic factor genotype, depression and anxiety, LBP history and baseline pain intensity, discriminated between those who did and did not report LBP at 6 months (C-statistic 0.91). This study identifies novel risk factors for the development of future LBP. Neurobiological risk factors, when added to a multivariable linear regression model, explained a further 15% of the variance in the 6-month pain intensity.
AB - Predicting the development of chronic low back pain (LBP) at the time of an acute episode remains challenging. The Understanding persistent Pain Where it ResiDes study aimed to identify neurobiological and psychological risk factors for chronic LBP. Individuals with acute LBP (N = 120) participated in a prospective cohort study with 6-month follow-up. Candidate predictors were selected from the neurobiological (eg, sensorimotor cortical excitability assessed by sensory and motor-evoked potentials and brain-derived neurotrophic factor genotype), psychological (eg, depression and anxiety), symptom-related (eg, LBP history), and demographic domains. Analyses involved multivariable linear regression models with pain intensity or disability degree as continuous variables. Secondary analyses involved a multivariable logistic model with the presence of LBP at 6 months (thresholding pain intensity and disability degree) as a dichotomous variable. Lower sensory cortex and corticomotor excitability, higher baseline pain intensity, higher depression, stress, and pain catastrophizing were the strongest predictors ( R2 = 0.47) of pain intensity at 6 months. Older age and higher pain catastrophizing were the strongest predictors ( R2 = 0.30) of disability at 6 months. When the LBP outcome was dichotomised, sensory cortex and corticomotor excitability, brain-derived neurotrophic factor genotype, depression and anxiety, LBP history and baseline pain intensity, discriminated between those who did and did not report LBP at 6 months (C-statistic 0.91). This study identifies novel risk factors for the development of future LBP. Neurobiological risk factors, when added to a multivariable linear regression model, explained a further 15% of the variance in the 6-month pain intensity.
KW - Acute Pain/complications
KW - Anxiety/psychology
KW - Brain-Derived Neurotrophic Factor
KW - Disability Evaluation
KW - Humans
KW - Low Back Pain/psychology
KW - Prognosis
KW - Prospective Studies
KW - Surveys and Questionnaires
KW - Low back pain, Prognostic factors, Sensorimotor cortex excitability, Plasticity, Brain-derived neurotrophic factor, Psychological, Sensory-evoked potential, Transcranial magnetic stimulation
UR - http://www.scopus.com/inward/record.url?scp=85144588890&partnerID=8YFLogxK
U2 - 10.1097/j.pain.0000000000002684
DO - 10.1097/j.pain.0000000000002684
M3 - Journal article
C2 - 35559930
SN - 0304-3959
VL - 164
SP - 14
EP - 26
JO - Pain
JF - Pain
IS - 1
ER -