Numerous neuroimaging studies have demonstrated that the brain plasticity is associated with chronic low back pain (cLBP). However, there is a lack of knowledge regarding the underlying mechanisms of thalamic pathways for chronic pain and psychological effects in cLBP caused by lumbar disc herniation (LDH). Combining psychophysics and magnetic resonance imaging (MRI), we investigated the structural and functional brain plasticity in 36 patients with LDH compared with 38 age- and gender-matched healthy controls. We found that (1) LDH patients had increased psychophysical disturbs (i.e., depression and anxiety), and depression (Beck-Depression Inventory, BDI) was found to be an outstanding significant factor to predict chronic pain (short form of the McGill Pain Questionnaire, SF-MPQ); (2) the LDH group showed significantly smaller fractional anisotropy values in the region of posterior corona radiate while gray matter volumes were comparable in both groups; (3) resting state functional connectivity analysis revealed that LDH patients exhibited increased temporal coupling between the thalamus and dorsolateral prefrontal cortex (DLPFC), which further mediate the relationship from chronic pain to depression. Our results emphasized that thalamic pathways underlying prefrontal cortex might play a key role in regulating chronic pain and depression of the pathophysiology of LDH.

中文翻译：

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丘脑和背外侧前额叶皮层之间增强的时间耦合介导慢性腰痛和抑郁症

许多神经影像学研究表明，大脑可塑性与慢性腰痛（cLBP）有关。然而，对于腰椎间盘突出症 (LDH) 引起的 cLBP 中慢性疼痛和心理影响的丘脑通路的潜在机制缺乏了解。结合心理物理学和磁共振成像 (MRI)，我们研究了 36 名 LDH 患者与 38 名年龄和性别匹配的健康对照者的大脑结构和功能可塑性。我们发现 (1) LDH 患者的心理生理障碍（即抑郁和焦虑）增加，而抑郁（Beck-Depression Inventory，BDI）被发现是预测慢性疼痛（McGill Pain Questionnaire 的简称, SF-MPQ); (2)LDH组在后冠辐射区的分数各向异性值明显较小，而两组灰质体积相当；(3) 静息状态功能连通性分析显示，LDH 患者的丘脑和背外侧前额叶皮层 (DLPFC) 之间的时间耦合增加，这进一步介导了慢性疼痛与抑郁的关系。我们的研究结果强调，前额叶皮层下的丘脑通路可能在调节慢性疼痛和 LDH 病理生理学的抑制中起关键作用。(3) 静息状态功能连通性分析显示，LDH 患者的丘脑和背外侧前额叶皮层 (DLPFC) 之间的时间耦合增加，这进一步介导了慢性疼痛与抑郁的关系。我们的研究结果强调，前额叶皮层下的丘脑通路可能在调节慢性疼痛和 LDH 病理生理学的抑制中起关键作用。(3) 静息状态功能连通性分析显示，LDH 患者的丘脑和背外侧前额叶皮层 (DLPFC) 之间的时间耦合增加，这进一步介导了慢性疼痛与抑郁的关系。我们的研究结果强调，前额叶皮层下的丘脑通路可能在调节慢性疼痛和 LDH 病理生理学的抑制中起关键作用。