View in EDS

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

Saved in:
Bibliographic Details
Title: 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
Authors: Sonia Medina, Carlos G. Forero, Juan P. Sanabria‐Mazo, Carla Rodríguez‐Freire, Jaime Navarrete, Owen G. O'Daly, Matthew A. Howard, Juan V. Luciano
Source: Brain Behav
Brain and Behavior, Vol 15, Iss 3, Pp n/a-n/a (2025)
Medina, S, Forero, C G, Sanabria-Mazo, J P, Rodríguez-Freire, C, Navarrete, J, O'Daly, O G, Howard, M A & Luciano, J V 2025, ' 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 ', Brain and Behavior, vol. 15, no. 3, e70380 . https://doi.org/10.1002/brb3.70380
Publisher Information: Wiley, 2025.
Publication Year: 2025
Subject Terms: Adult, Chronic Pain/therapy, Nerve Net/physiopathology, Chronic pain, BATD, Neurosciences. Biological psychiatry. Neuropsychiatry, Depression/therapy, Comorbidity, Catastrophization/physiopathology, Depresión, Humans, Acceptance and Commitment Therapy, Sensorimotor Cortex/physiopathology, Cognitive Behavioral Therapy, Depression, Catastrophization, Cognitive Behavioral Therapy/methods, fMRI, Brain, Middle Aged, Dolor crónico, Brain/diagnostic imaging, Dolor crònic, ACT, Magnetic Resonance Imaging, Treatment Outcome, Low Back Pain/therapy, depression, Original Article, Female, Sensorimotor Cortex, Acceptance and Commitment Therapy/methods, Chronic Pain, Nerve Net, Depressió, chronic pain, Low Back Pain, RC321-571
Description: 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.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 2162-3279
DOI: 10.1002/brb3.70380
Access URL: https://pubmed.ncbi.nlm.nih.gov/40022281
https://doaj.org/article/95c677d9912640b7a5afd10f76690d62
https://kclpure.kcl.ac.uk/ws/files/333032182/Brain_and_Behavior_-_2025_-_Medina_-_Baseline_Functional_Connectivity_of_the_Mesolimbic_Salience_and_Sensorimotor_Systems.pdf
Rights: CC BY
Accession Number: edsair.doi.dedup.....04b984a4f15239c1480e3bd87569fddf
Database: OpenAIRE
Description
Abstract: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.
ISSN:21623279
DOI:10.1002/brb3.70380