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Disrupted interhemispheric functional coordination in patients with chronic low back-related leg pain: a multiscale frequency-related homotopic connectivity study

Authors Zhang Y, Zhu Y, Pei Y, Zhao Y, Zhou F, Huang M, Wu L, Zhang D, Gong H

Received 26 April 2019

Accepted for publication 6 August 2019

Published 28 August 2019 Volume 2019:12 Pages 2615—2626

DOI https://doi.org/10.2147/JPR.S213526

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr E Alfonso Romero-Sandoval


Yong Zhang,1 Yanyan Zhu,2,3 Yixiu Pei,2,3 Yanlin Zhao,2,3 Fuqing Zhou,2,3 Muhua Huang,2,3 Lin Wu,2,3 Daying Zhang,1 Honghan Gong2,3

1Department of Pain Clinic, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province 330006, People’s Republic of China; 2Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang 330006, People’s Republic of China; 3Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang 330006, People’s Republic of China

Correspondence: Fuqing Zhou
Department of Radiology, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, 
Nanchang, Jiangxi 330006, People’s Republic of China
Tel +86 7 918 869 5132
Email fq.chou@yahoo.com

Daying Zhang
Department of Pain Clinic, The First Affiliated Hospital, Nanchang University, 17 Yongwaizheng Street, 
Nanchang, Jiangxi 330006, People’s Republic of China
Tel +86 7 918 869 3825
Email dyzsino@ncu.edu.cn

Objective: Chronic low back pain has been observed to decrease movement coordination. However, it is unclear whether the existing alteration of inter-hemispheric synchrony of intrinsic activity in patients with chronic low back-related leg pain (cLBLP). The present study aims to investigate the alteration of homotopic connectivity and its clinical association with the cLBLP patients.
Participants and methods: A cohort of cLBLP patients (n=25) and well-matched healthy controls (HCs) (n=27) were recruited and underwent MRI scanning and a battery of clinical tests. The voxel-mirrored homotopic connectivity (VMHC) was used to analyze the interhemispheric coordination in the typical (0.01–0.1 Hz) as well as five specific (slow-6 to slow-2) frequency bands and associated with clinical index in cLBLP patients.
Results: We observed that cLBLP patients with lower homotopic connectivity than HCs in the inferior temporal gyrus, the superior temporal gyrus, the basal ganglia, the middle frontal gyrus, and the medial prefrontal cortex in the typical and five specific frequency bands, respectively. In the typical and five specific frequency bands, significant positive correlations were observed between the VMHC values of medial prefrontal cortex and the visual analogue scale scores, while the VMHC values of basal ganglia negative correlated with the values of two-point tactile discrimination (2PD) test for the right hand in cLBLP patients, etc. Further receiver operating characteristic curve analysis revealed that VMHC in the above regions with decreased could be used to differentiate the cerebral functional plasticity of cLBLP from healthy individuals with high sensitivity and specificity.
Conclusion: Our results imply that multiscale frequency-related interhemispheric disconnectivity may underlie the central pathogenesis of functional coordination in patients with cLBLP.

Keywords: interhemispheric integration, voxel-mirrored homotopic connectivity, chronic low back-related leg pain, chronic pain, resting-state fMRI

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