Baseline functional connectivity of the Mesolimbic, Salience, and Sensorimotor Systems predicts responses to psychological therapies for chronic low back pain with comorbid depression : a functional MRI study
Medina, Sonia (King's College London. Department of Neuroimaging)
Forero, Carlos G. (Universitat Internacional de Catalunya)
Sanabria-Mazo, Juan P. (Parc Sanitari Sant Joan de Déu)
Rodríguez Freire, Carla (Parc Sanitari Sant Joan de Déu)
Navarrete Hidalgo, Jaime (Parc Sanitari Sant Joan de Déu)
O'Daly, Owen G. (King's College London. Department of Neuroimaging)
Howard, Matthew A. (King's College London. Department of Neuroimaging)
Luciano, Juan V. (Parc Sanitari Sant Joan de Déu)
Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut

Data:	2025
Descripció:	13 pàg.
Resum:	INTRODUCTION: Chronic low back pain (CLBP) is a prevalent and debilitating condition. Cognitive behavioral therapy (CBT) can improve coping mechanisms for CLBP and pain-related outcomes. However, the mechanisms by which they do so remain undetermined. We explored the neural correlates of CLBP symptoms and CBT action using functional magnetic resonance imaging (fMRI) in women with CLBP and comorbid depression. METHODS: Forty individuals underwent fMRI followed by 8 weeks of either treatment as usual (TAU) or one of two CBT in addition to TAU: acceptance and commitment therapy (ACT) or behavioral activation treatment for depression (BATD). Pain intensity, depression, psychological inflexibility, and pain catastrophizing scores were obtained at baseline and follow-up. Functional connectivity (FC) patterns of the salience network (SN), sensorimotor network (SMN), and the mesolimbic pathway (MLP), derived from resting-state fMRI examination were correlated with both baseline and delta (baseline-follow-up) pain-related psychological measures. RESULTS: Individuals receiving ACT and BATD showed reduced depression, psychological inflexibility, and pain catastrophizing. Strong baseline connectivity of the SN and SMN corresponded with higher pain intensity, but strong connectivity of the MLP and precuneus corresponded with lower pain intensity. Pain intensity changes correlated with mesolimbic-salience connectivity following ACT, and with sensorimotor connectivity following BATD. Specifically, stronger baseline FC between the MLP and posterior insula predicted greater pain intensity reduction with ACT, while stronger FC between the SMN and secondary somatosensory cortex predicted greater pain intensity reduction with BATD. FC of the SN correlated with changes in psychological inflexibility across both therapies. CONCLUSIONS: We illustrate the potential of FC as a biomarker of CLBP plus depression and the response to CBT. Our data suggest ACT and BATD have differing underlying brain mechanisms. These findings indicate that FC biomarkers could guide personalized treatment, improving individual outcomes.
Nota:	Altres ajuts: acords transformatius de la UAB
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	ACT ; BATD ; Chronic pain ; Depression ; FMRI ; Low Back Pain ; Cognitive Behavioral Therapy ; Catastrophization ; Nerve Net ; Comorbidity ; Sensorimotor Cortex ; Còrtex Sensorimotor ; Dolor de espalda baja ; Dolor crónico ; Terápia Cognitivo Conductual ; Depresión ; Catastrofitzación ; Red Nerviosa ; Comorbilidad ; Mal d'esquena baixa ; Dolor crònic ; Teràpia Cognitiu Conductual ; Depressió ; Catastrofització ; Xarxa Nerviosa ; Comorbiditat
Publicat a:	Brain and behavior, Vol. 15 Núm. 3 (2025) , art.70380, ISSN 2162-3279

DOI: 10.1002/brb3.70380
PMID: 40022281

13 p, 1.7 MB

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