Baseline functional connectivity of the Mesolimbic, Salience, and Sensorimotor Systems predicts responses to psychological therapies for chronic low back pain with comorbid depression

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 sympto...

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Autores: Medina, Sonia|||0000-0001-8883-6520, Forero, Carlos G.|||0000-0002-5245-0076, Sanabria-Mazo, Juan P.|||0000-0003-1688-435X, Rodríguez Freire, Carla|||0009-0006-6728-5778, Navarrete Hidalgo, Jaime|||0000-0002-9482-4822, O'Daly, Owen G.|||0000-0001-5690-1252, Howard, Matthew A.|||0000-0002-9359-3057, Luciano, Juan Vicente|||0000-0003-0750-1599
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:310123
Acceso en línea:https://ddd.uab.cat/record/310123
https://dx.doi.org/urn:doi:10.1002/brb3.70380
Access Level:acceso abierto
Palabra clave: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
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network_acronym_str ES
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spelling Baseline functional connectivity of the Mesolimbic, Salience, and Sensorimotor Systems predicts responses to psychological therapies for chronic low back pain with comorbid depressiona functional MRI studyMedina, Sonia|||0000-0001-8883-6520Forero, Carlos G.|||0000-0002-5245-0076Sanabria-Mazo, Juan P.|||0000-0003-1688-435XRodríguez Freire, Carla|||0009-0006-6728-5778Navarrete Hidalgo, Jaime|||0000-0002-9482-4822O'Daly, Owen G.|||0000-0001-5690-1252Howard, Matthew A.|||0000-0002-9359-3057Luciano, Juan Vicente|||0000-0003-0750-1599ACTBATDChronic painDepressionFMRILow Back PainCognitive Behavioral TherapyCatastrophizationNerve NetComorbiditySensorimotor CortexCòrtex SensorimotorDolor de espalda bajaDolor crónicoTerápia Cognitivo ConductualDepresiónCatastrofitzaciónRed NerviosaComorbilidadMal d'esquena baixaDolor crònicTeràpia Cognitiu ConductualDepressióCatastrofitzacióXarxa NerviosaComorbiditatINTRODUCTION: 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.Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut 22025-01-0120252025-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/310123https://dx.doi.org/urn:doi:10.1002/brb3.70380reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquesta url de drets no existeix a la base de dades.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3101232026-06-06T12:50:31Z
dc.title.none.fl_str_mv 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
title Baseline functional connectivity of the Mesolimbic, Salience, and Sensorimotor Systems predicts responses to psychological therapies for chronic low back pain with comorbid depression
spellingShingle Baseline functional connectivity of the Mesolimbic, Salience, and Sensorimotor Systems predicts responses to psychological therapies for chronic low back pain with comorbid depression
Medina, Sonia|||0000-0001-8883-6520
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
title_short Baseline functional connectivity of the Mesolimbic, Salience, and Sensorimotor Systems predicts responses to psychological therapies for chronic low back pain with comorbid depression
title_full Baseline functional connectivity of the Mesolimbic, Salience, and Sensorimotor Systems predicts responses to psychological therapies for chronic low back pain with comorbid depression
title_fullStr Baseline functional connectivity of the Mesolimbic, Salience, and Sensorimotor Systems predicts responses to psychological therapies for chronic low back pain with comorbid depression
title_full_unstemmed Baseline functional connectivity of the Mesolimbic, Salience, and Sensorimotor Systems predicts responses to psychological therapies for chronic low back pain with comorbid depression
title_sort Baseline functional connectivity of the Mesolimbic, Salience, and Sensorimotor Systems predicts responses to psychological therapies for chronic low back pain with comorbid depression
dc.creator.none.fl_str_mv Medina, Sonia|||0000-0001-8883-6520
Forero, Carlos G.|||0000-0002-5245-0076
Sanabria-Mazo, Juan P.|||0000-0003-1688-435X
Rodríguez Freire, Carla|||0009-0006-6728-5778
Navarrete Hidalgo, Jaime|||0000-0002-9482-4822
O'Daly, Owen G.|||0000-0001-5690-1252
Howard, Matthew A.|||0000-0002-9359-3057
Luciano, Juan Vicente|||0000-0003-0750-1599
author Medina, Sonia|||0000-0001-8883-6520
author_facet Medina, Sonia|||0000-0001-8883-6520
Forero, Carlos G.|||0000-0002-5245-0076
Sanabria-Mazo, Juan P.|||0000-0003-1688-435X
Rodríguez Freire, Carla|||0009-0006-6728-5778
Navarrete Hidalgo, Jaime|||0000-0002-9482-4822
O'Daly, Owen G.|||0000-0001-5690-1252
Howard, Matthew A.|||0000-0002-9359-3057
Luciano, Juan Vicente|||0000-0003-0750-1599
author_role author
author2 Forero, Carlos G.|||0000-0002-5245-0076
Sanabria-Mazo, Juan P.|||0000-0003-1688-435X
Rodríguez Freire, Carla|||0009-0006-6728-5778
Navarrete Hidalgo, Jaime|||0000-0002-9482-4822
O'Daly, Owen G.|||0000-0001-5690-1252
Howard, Matthew A.|||0000-0002-9359-3057
Luciano, Juan Vicente|||0000-0003-0750-1599
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut
dc.subject.none.fl_str_mv 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
topic 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
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.
publishDate 2025
dc.date.none.fl_str_mv 2
2025-01-01
2025
2025-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/310123
https://dx.doi.org/urn:doi:10.1002/brb3.70380
url https://ddd.uab.cat/record/310123
https://dx.doi.org/urn:doi:10.1002/brb3.70380
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Aquesta url de drets no existeix a la base de dades.
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Aquesta url de drets no existeix a la base de dades.
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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