Gray Matter Morphology and Pain-related Disability in Young Adults with Low Back Pain

Authors

Jo Armour Smith, Chapman UniversityFollow
Rongwen Tain, University of California, Irvine
Isaac Chrisman, Chapman UniversityFollow
Kelli G. Sharp, University of California, Irvine
Laura M. Glynn, Chapman UniversityFollow
Linda R. Van Dillen, Washington University in St. Louis
Jesse V. Jacobs, University of Vermont
Steven C. Cramer, University of California, Irvine

Document Type

Article

Publication Date

4-17-2025

Abstract

Structural neuroplasticity in the brain may contribute to the persistence of low back pain (LBP) symptoms and the disability associated with them. It is not known if structural adaptations are evident early in the lifespan in young adults with LBP. This study compared gray matter in cortical sensorimotor regions in young adults with and without persistent LBP and identified gray matter and clinical predictors of pain-related disability. Eighty-two individuals with and without a history of LBP participated. Peak and average gray matter density in cortical sensorimotor regions of interest was quantified using voxel-based morphometry. Pain-related disability, pain intensity, pain duration, and pain-related fear were also assessed. Multiple linear regression was used to determine independent predictors of pain-related disability. We document significantly greater peak gray matter density in individuals with LBP in the primary somatosensory cortex, angular gyrus, and the midcingulate cortex. Pain-related disability positively correlated with average gray matter density in the posterior cingulate cortex. The most robust predictors of disability were average gray matter in the posterior cingulate, pain intensity, and pain-related fear. We demonstrate that in young adults, persistent LBP, and pain-related disability, are linked with structural differences in regions forming part of the brain network termed the pain matrix. In contrast with studies of LBP in older adults, our findings of increased rather than decreased gray matter in young adults with LBP suggest that gray matter may increase initially in response to nociceptive pain.

Comments

This article was originally published in NeuroImage, volume 312, in 2025. https://doi.org/10.1016/j.neuroimage.2025.121227

This article was the recipient of a Chapman University Supporting Open Access Research and Scholarship (SOARS) award.

Recommended Citation

Smith JA, Tain R, Chrisman I, et al. Gray matter morphology and pain-related disability in young adults with low back pain. NeuroImage. 2025;312:121227. https://doi.org/10.1016/j.neuroimage.2025.121227

Peer Reviewed

1

Copyright

The authors

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.