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Guekos A, Cole DM, Dörig M, Stämpfli P, Schibli L, Schuetz P, Schweinhardt P, Meier ML. BackWards - Unveiling the brain's topographic organization of paraspinal sensory input. Neuroimage 2023; 283:120431. [PMID: 37914091 DOI: 10.1016/j.neuroimage.2023.120431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/03/2023] Open
Abstract
Cortical reorganization and its potential pathological significance are being increasingly studied in musculoskeletal disorders such as chronic low back pain (CLBP) patients. However, detailed sensory-topographic maps of the human back are lacking, and a baseline characterization of such representations, reflecting the somatosensory organization of the healthy back, is needed before exploring potential sensory map reorganization. To this end, a novel pneumatic vibrotactile stimulation method was used to stimulate paraspinal sensory afferents, while studying their cortical representations in unprecedented detail. In 41 young healthy participants, vibrotactile stimulations at 20 Hz and 80 Hz were applied bilaterally at nine locations along the thoracolumbar axis while functional magnetic resonance imaging (fMRI) was performed. Model-based whole-brain searchlight representational similarity analysis (RSA) was used to investigate the organizational structure of brain activity patterns evoked by thoracolumbar sensory inputs. A model based on segmental distances best explained the similarity structure of brain activity patterns that were located in different areas of sensorimotor cortices, including the primary somatosensory and motor cortices and parts of the superior parietal cortex, suggesting that these brain areas process sensory input from the back in a "dermatomal" manner. The current findings provide a sound basis for testing the "cortical map reorganization theory" and its pathological relevance in CLBP.
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Affiliation(s)
- Alexandros Guekos
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; Decision Neuroscience Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland; Neuroscience Center Zurich (ZNZ), Zurich, Switzerland.
| | - David M Cole
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Switzerland
| | - Monika Dörig
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; School of Engineering and Architecture, Lucerne University of Applied Sciences and Arts, Horw, Switzerland
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Switzerland; MR-Center of the Psychiatric University Hospital, Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland
| | - Louis Schibli
- Competence Center Thermal Energy Storage, Lucerne University of Applied Sciences and Art, Horw, Switzerland
| | - Philipp Schuetz
- Competence Center Thermal Energy Storage, Lucerne University of Applied Sciences and Art, Horw, Switzerland
| | - Petra Schweinhardt
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich (ZNZ), Zurich, Switzerland
| | - Michael L Meier
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich (ZNZ), Zurich, Switzerland
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Kawai K, Kato Y, Ito T, Yamazaki K, Fukuhara J, Sakai Y, Morita Y. Biological Responses to Local Vibratory Stimulation for the Lower Legs and Lower Back and Criterion Values Based on Sweep Frequencies of Healthy Individuals: An Observational Study. Healthcare (Basel) 2023; 11:2243. [PMID: 37628441 PMCID: PMC10454103 DOI: 10.3390/healthcare11162243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/12/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
Declining proprioceptive function is associated with problems such as lower back pain and falls. Therefore, we developed a vibration device using sweep frequency to evaluate several proprioceptors with different response frequency ranges. This study aimed to elucidate the biological responses of healthy individuals to vibratory stimulation at different sites and frequency ranges and to propose cutoff values to determine the decline in proprioceptive function. Mechanical vibration was separately applied to the lower legs and lower back, and proprioceptive function was evaluated by defining the ratio of the center of pressure (CoP) in the anteroposterior direction during mechanical vibration to that during no vibration in the three frequency ranges. The cut-off value was defined as the mean value, with the standard deviation subtracted for each indicator. The cut-off values were higher in the lower legs than in the lower back at all frequency ranges and in the 30-53 Hz and 56-100 Hz frequency ranges for both the lower legs and lower back. In healthy individuals, 9.9% and 8.6% were below the cut-off values in the 30-53 Hz and 56-100 Hz frequency ranges for the lower legs, respectively.
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Affiliation(s)
- Keitaro Kawai
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan; (K.K.); (J.F.)
| | - Yoshiji Kato
- Department of Physical Therapy, Nagoya Women’s University, Nagoya 467-8610, Japan;
| | - Tadashi Ito
- Three-Dimensional Motion Analysis Room, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities, Okazaki 444-0002, Japan;
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya 461-8673, Japan
| | - Kazunori Yamazaki
- Institutional Research Center, Aichi Mizuho College, Nagoya 467-0867, Japan;
| | - Jo Fukuhara
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan; (K.K.); (J.F.)
| | - Yoshihito Sakai
- Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan;
| | - Yoshifumi Morita
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan; (K.K.); (J.F.)
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Travassos C, Sayal A, Direito B, Pereira J, Sousa T, Castelo-Branco M. Assessing MR-compatibility of somatosensory stimulation devices: A systematic review on testing methodologies. Front Neurosci 2023; 17:1071749. [PMID: 36777636 PMCID: PMC9909190 DOI: 10.3389/fnins.2023.1071749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/03/2023] [Indexed: 01/27/2023] Open
Abstract
Functional magnetic resonance imaging (fMRI) has been extensively used as a tool to map the brain processes related to somatosensory stimulation. This mapping includes the localization of task-related brain activation and the characterization of brain activity dynamics and neural circuitries related to the processing of somatosensory information. However, the magnetic resonance (MR) environment presents unique challenges regarding participant and equipment safety and compatibility. This study aims to systematically review and analyze the state-of-the-art methodologies to assess the safety and compatibility of somatosensory stimulation devices in the MR environment. A literature search, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines, was performed in PubMed, Scopus, and Web of Science to find original research on the development and testing of devices for somatosensory stimulation in the MR environment. Nineteen records that complied with the inclusion and eligibility criteria were considered. The findings are discussed in the context of the existing international standards available for the safety and compatibility assessment of devices intended to be used in the MR environment. In sum, the results provided evidence for a lack of uniformity in the applied testing methodologies, as well as an in-depth presentation of the testing methodologies and results. Lastly, we suggest an assessment methodology (safety, compatibility, performance, and user acceptability) that can be applied to devices intended to be used in the MR environment. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42021257838.
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Affiliation(s)
- Carolina Travassos
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra (UC), Coimbra, Portugal
- Siemens Healthineers AG, Lisbon, Portugal
| | - Alexandre Sayal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra (UC), Coimbra, Portugal
- Siemens Healthineers AG, Lisbon, Portugal
| | - Bruno Direito
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra (UC), Coimbra, Portugal
- Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra (UC), Coimbra, Portugal
- Instituto do Ambiente, Tecnologia e Vida (IATV), Coimbra, Portugal
| | - João Pereira
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra (UC), Coimbra, Portugal
| | - Teresa Sousa
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra (UC), Coimbra, Portugal
- Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra (UC), Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra (UC), Coimbra, Portugal
- Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra (UC), Coimbra, Portugal
- Faculty of Medicine (FMUC), University of Coimbra (UC), Coimbra, Portugal
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Cole DM, Stämpfli P, Gandia R, Schibli L, Gantner S, Schuetz P, Meier ML. In the back of your mind: Cortical mapping of paraspinal afferent inputs. Hum Brain Mapp 2022; 43:4943-4953. [PMID: 35979921 PMCID: PMC9582373 DOI: 10.1002/hbm.26052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/22/2022] [Accepted: 08/02/2022] [Indexed: 11/06/2022] Open
Abstract
Topographic organisation is a hallmark of vertebrate cortex architecture, characterised by ordered projections of the body's sensory surfaces onto brain systems. High-resolution functional magnetic resonance imaging (fMRI) has proven itself as a valuable tool to investigate the cortical landscape and its (mal-)adaptive plasticity with respect to various body part representations, in particular extremities such as the hand and fingers. Less is known, however, about the cortical representation of the human back. We therefore validated a novel, MRI-compatible method of mapping cortical representations of sensory afferents of the back, using vibrotactile stimulation at varying frequencies and paraspinal locations, in conjunction with fMRI. We expected high-frequency stimulation to be associated with differential neuronal activity in the primary somatosensory cortex (S1) compared with low-frequency stimulation and that somatosensory representations would differ across the thoracolumbar axis. We found significant differences between neural representations of high-frequency and low-frequency stimulation and between representations of thoracic and lumbar paraspinal locations, in several bilateral S1 sub-regions, and in regions of the primary motor cortex (M1). High-frequency stimulation preferentially activated Brodmann Area (BA) regions BA3a and BA4p, whereas low-frequency stimulation was more encoded in BA3b and BA4a. Moreover, we found clear topographic differences in S1 for representations of the upper and lower back during high-frequency stimulation. We present the first neurobiological validation of a method for establishing detailed cortical maps of the human back, which might serve as a novel tool to evaluate the pathological significance of neuroplastic changes in clinical conditions such as chronic low back pain.
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Affiliation(s)
- David M Cole
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.,MR-Center of the Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Robert Gandia
- Competence Center Thermal Energy Storage, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
| | - Louis Schibli
- Competence Center Thermal Energy Storage, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
| | - Sandro Gantner
- Competence Center Thermal Energy Storage, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
| | - Philipp Schuetz
- Competence Center Thermal Energy Storage, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
| | - Michael L Meier
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
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Li W, Li C, Liu P, Li Y, Xiang Y, Jia T, Xu Q, Ji L. Development and Preliminary Validation of a Pneumatic Focal Vibration System to the Mitigation of Post-Stroke Spasticity. IEEE Trans Neural Syst Rehabil Eng 2021; 29:380-388. [PMID: 33460383 DOI: 10.1109/tnsre.2021.3052187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Some evidence has demonstrated that focal vibration (FV) plays an important role in the mitigation of spasticity. However, the research on developing the FV system to mitigate the spasticity effectively has been seldom reported. To relieve post-stroke spasticity, a new pneumatic FV system has been proposed in this paper. An image processing approach, in which the edge of vibration actuator was identified by the Canny edge detector, was utilized to quantify this system's parameters: the frequency ranging from 44 Hz to 128 Hz and the corresponding amplitude. Taking one FV protocol with the frequency of 87 Hz and the amplitude 0.28 mm of this system as an example, a clinical experiment was carried out. In the clinical experiment, FV was applied over the muscle belly of the antagonist of spastic muscle for twelve chronic spastic stroke patients. Spasticity was quantified by the muscle compliance and area under the curve for muscle (AUC_muscle). The result has demonstrated that, in the state of flexion of spastic muscle, the AUC_muscle and muscle compliance of the spastic muscle significantly increased immediately after FV compared with before-FV, illustrating the mitigation of the spasticity. This study will not only provide a potential tool to relieve post-stroke spasticity, but also contribute to improving the sensory and motor function of patients with other neurological diseases, e.g. spinal cord injury, multiple sclerosis, Parkinson and dystonia, etc.
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Changes in the Organization of the Secondary Somatosensory Cortex While Processing Lumbar Proprioception and the Relationship With Sensorimotor Control in Low Back Pain. Clin J Pain 2020; 35:394-406. [PMID: 30730445 DOI: 10.1097/ajp.0000000000000692] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Patients with nonspecific low back pain (NSLBP) rely more on the ankle compared with the lower back proprioception while standing, perform sit-to-stand-to-sit (STSTS) movements slower, and exhibit perceptual impairments at the lower back. However, no studies investigated whether these sensorimotor impairments relate to a reorganization of the primary and secondary somatosensory cortices (S1 and S2) and primary motor cortex (M1) during proprioceptive processing. MATERIALS AND METHODS Proprioceptive stimuli were applied at the lower back and ankle muscles during functional magnetic resonance imaging in 15 patients with NSLBP and 13 controls. The location of the activation peaks during the processing of proprioception within S1, S2, and M1 were determined and compared between groups. Proprioceptive use during postural control was evaluated, the duration to perform 5 STSTS movements was recorded, and participants completed the Fremantle Back Awareness Questionnaire (FreBAQ) to assess back-specific body perception. RESULTS The activation peak during the processing of lower back proprioception in the right S2 was shifted laterally in the NSLBP group compared with the healthy group (P=0.007). Moreover, patients with NSLSP performed STSTS movements slower (P=0.018), and reported more perceptual impairments at the lower back (P<0.001). Finally, a significant correlation between a more lateral location of the activation peak during back proprioceptive processing and a more disturbed body perception was found across the total group (ρ=0.42, P=0.025). CONCLUSIONS The results suggest that patients with NSLBP show a reorganization of the higher-order processing of lower back proprioception, which could negatively affect spinal control and body perception.
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Jiang X, Wang Y, Li X, Wang L, Zhou YD, Wang H. A Simple and Compact MR-Compatible Electromagnetic Vibrotactile Stimulator. Front Neurosci 2020; 13:1403. [PMID: 32009884 PMCID: PMC6978794 DOI: 10.3389/fnins.2019.01403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/12/2019] [Indexed: 12/26/2022] Open
Abstract
We have developed a low-cost electromagnetic vibrotactile stimulator that uses the magnetic field of an MR scanner as a permanent magnet to power a vibrating motor. A simple variable current power supply is controlled by software using a USB data acquisition controller. In our study, the function of our novel stimulator was verified in a vibration frequency discrimination working memory task, in which various ranges of frequencies and amplitudes are delivered in MRI scanner. Furthermore, our functional MRI study revealed activations of the primary and secondary somatosensory cortices during the perception of tactile stimulation. Therefore, the new designed electromagnetic vibrotactile stimulator is capable of generating various frequencies of tactile stimuli and represents a powerful and useful tool for studying somatosensory functions with functional MRI.
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Affiliation(s)
- Xinjian Jiang
- Key Laboratory of Brain Functional Genomics (MOE & STCSM), School of Psychology and Cognitive Science, Institute of Cognitive Neuroscience, East China Normal University, Shanghai, China
| | - Yueqian Wang
- Key Laboratory of Brain Functional Genomics (MOE & STCSM), School of Psychology and Cognitive Science, Institute of Cognitive Neuroscience, East China Normal University, Shanghai, China
| | - Xiaojin Li
- Department of Electronic Engineering, School of Information Science and Technology, East China Normal University, Shanghai, China
| | - Liping Wang
- Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Yong-Di Zhou
- Key Laboratory of Brain Functional Genomics (MOE & STCSM), School of Psychology and Cognitive Science, Institute of Cognitive Neuroscience, East China Normal University, Shanghai, China
| | - Huimin Wang
- Key Laboratory of Brain Functional Genomics (MOE & STCSM), School of Psychology and Cognitive Science, Institute of Cognitive Neuroscience, East China Normal University, Shanghai, China
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Goossens N, Janssens L, Caeyenberghs K, Albouy G, Brumagne S. Differences in brain processing of proprioception related to postural control in patients with recurrent non-specific low back pain and healthy controls. NEUROIMAGE-CLINICAL 2019; 23:101881. [PMID: 31163385 PMCID: PMC6545448 DOI: 10.1016/j.nicl.2019.101881] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 04/19/2019] [Accepted: 05/25/2019] [Indexed: 12/11/2022]
Abstract
Patients with non-specific low back pain (NSLBP) show an impaired postural control during standing and a slower performance of sit-to-stand-to-sit (STSTS) movements. Research suggests that these impairments could be due to an altered use of ankle compared to back proprioception. However, the neural correlates of these postural control impairments in NSLBP remain unclear. Therefore, we investigated brain activity during ankle and back proprioceptive processing by applying local muscle vibration during functional magnetic resonance imaging in 20 patients with NSLBP and 20 controls. Correlations between brain activity during proprioceptive processing and (Airaksinen et al., 2006) proprioceptive use during postural control, evaluated by using muscle vibration tasks during standing, and (Altmann et al., 2007) STSTS performance were examined across and between groups. Moreover, fear of movement was assessed. Results revealed that the NSLBP group performed worse on the STSTS task, and reported more fear compared to healthy controls. Unexpectedly, no group differences in proprioceptive use during postural control were found. However, the relationship between brain activity during proprioceptive processing and behavioral indices of proprioceptive use differed significantly between NSLBP and healthy control groups. Activity in the right amygdala during ankle proprioceptive processing correlated with an impaired proprioceptive use in the patients with NSLBP, but not in healthy controls. Moreover, while activity in the left superior parietal lobule, a sensory processing region, during back proprioceptive processing correlated with a better use of proprioception in the NSLBP group, it was associated with a less optimal use of proprioception in the control group. These findings suggest that functional brain changes during proprioceptive processing in patients with NSLBP may contribute to their postural control impairments.
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Affiliation(s)
- Nina Goossens
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, box 1501, Leuven 3001, Belgium.
| | - Lotte Janssens
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, box 1501, Leuven 3001, Belgium; REVAL Rehabilitation Research Center, Hasselt University, Agoralaan A, Diepenbeek 3590, Belgium
| | - Karen Caeyenberghs
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Melbourne Campus (St Patrick), Locked Bag 4115, Fitzroy, VIC 3065, Australia
| | - Geneviève Albouy
- Department of Movement Sciences, KU Leuven, Tervuursevest 101, box 1501, Leuven 3001, Belgium
| | - Simon Brumagne
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, box 1501, Leuven 3001, Belgium
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Association Between Sensorimotor Impairments and Functional Brain Changes in Patients With Low Back Pain: A Critical Review. Am J Phys Med Rehabil 2019; 97:200-211. [PMID: 29112509 DOI: 10.1097/phm.0000000000000859] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Low back pain (LBP) coincides with sensorimotor impairments, for example, reduced lumbosacral tactile and proprioceptive acuity and postural control deficits. Recent functional magnetic resonance imaging studies suggest that sensorimotor impairments in LBP may be associated with brain changes. However, no consensus exists regarding the relationship between functional brain changes and sensorimotor behavior in LBP. Therefore, this review critically discusses the available functional magnetic resonance imaging studies on brain activation related to nonnociceptive somatosensory stimulation and motor performance in individuals with LBP. Four electronic databases were searched, yielding nine relevant studies. Patients with LBP showed reduced sensorimotor-related brain activation and a reorganized lumbar spine representation in higher-order (multi)sensory processing and motor regions, including primary and secondary somatosensory cortices, supplementary motor area, and superior temporal gyrus. These results may support behavioral findings of sensorimotor impairments in LBP. In addition, patients with LBP displayed widespread increased sensorimotor-evoked brain activation in regions often associated with abnormal pain processing. Overactivation in these regions could indicate an overresponsiveness to sensory inputs that signal potential harm to the spine, thereby inducing overgeneralized protective responses. Hence, functional brain changes could contribute to the development and recurrence of LBP. However, future studies investigating the causality between sensorimotor-related brain function and LBP are imperative.
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Systematic Review of fMRI Compatible Devices: Design and Testing Criteria. Ann Biomed Eng 2017; 45:1819-1835. [DOI: 10.1007/s10439-017-1853-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 05/10/2017] [Indexed: 12/22/2022]
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