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Are Functional Brain Alterations Present in Low Back Pain? A Systematic Review of EEG Studies

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Abstract
This systematic review analyzed available literature on functional brain alterations in low back pain (LBP) measured with electroencephalography (EEG), as until now evidence thereof was unclear. Four electronic databases were systematically searched the 10th of March 2018, resulting in 12 included studies. Studies showed a risk of bias of 37.5 to 75% using the Newcastle-Ottawa Scale for case-control studies. Limited evidence reported higher amplitudes of balance-related potentials and early components of somatosensory evoked potentials (SEP) to noxious stimuli, and altered feedback-related negativity and P300 potentials during decision-making in chronic LBP (CLBP). These findings suggest postural strategies requiring a higher cortical attention-demand, increased sensorydiscriminative processing of noxious input, and altered decision-making in CLBP. However, further research is warranted as these inferences were based on single studies. Moderate evidence for unaltered amplitude of late-phase SEPs to noxious stimuli and auditory evoked potentials in LBP implies that the affective-emotional processing of stimuli might be unaffected in LBP. Furthermore, moderate evidence indicated disturbed habituation of somatosensory stimuli in LBP. Most studies examined nonspecific or mixed CLBP populations, hence EEG-quantified brain activity in (sub)acute or recurrent LBP still needs to be explored. Perspective: This review presents an overview of the current understanding of the functional LBP brain measured with EEG. The limited evidence in current research suggests altered cortical function regarding balance control, somatosensory processing, and decision making in LBP, and highlights opportunities for future EEG-research.
Keywords
Low back pain, Electroencephalography, Evoked potential, Central nervous system, Neurology, Clinical Neurology

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Please use this url to cite or link to this publication:

Chicago
Schouppe, Stijn, Sophie Van Oosterwijck, Lieven Danneels, Stefaan Van Damme, and Jessica Van Oosterwijck. 2019. “Are Functional Brain Alterations Present in Low Back Pain? A Systematic Review of EEG Studies.” The Journal of Pain.
APA
Schouppe, S., Van Oosterwijck, S., Danneels, L., Van Damme, S., & Van Oosterwijck, J. (2019). Are Functional Brain Alterations Present in Low Back Pain? A Systematic Review of EEG Studies. The Journal of Pain.
Vancouver
1.
Schouppe S, Van Oosterwijck S, Danneels L, Van Damme S, Van Oosterwijck J. Are Functional Brain Alterations Present in Low Back Pain? A Systematic Review of EEG Studies. The Journal of Pain. 2019;
MLA
Schouppe, Stijn et al. “Are Functional Brain Alterations Present in Low Back Pain? A Systematic Review of EEG Studies.” The Journal of Pain (2019): n. pag. Print.
@article{8624099,
  abstract     = {This systematic review analyzed available literature on functional brain alterations in low
back pain (LBP) measured with electroencephalography (EEG), as until now evidence thereof was
unclear. Four electronic databases were systematically searched the 10th of March 2018, resulting in
12 included studies. Studies showed a risk of bias of 37.5 to 75% using the Newcastle-Ottawa Scale
for case-control studies. Limited evidence reported higher amplitudes of balance-related potentials
and early components of somatosensory evoked potentials (SEP) to noxious stimuli, and altered feedback-related negativity and P300 potentials during decision-making in chronic LBP (CLBP). These findings suggest postural strategies requiring a higher cortical attention-demand, increased sensorydiscriminative processing of noxious input, and altered decision-making in CLBP. However, further
research is warranted as these inferences were based on single studies. Moderate evidence for unaltered amplitude of late-phase SEPs to noxious stimuli and auditory evoked potentials in LBP implies
that the affective-emotional processing of stimuli might be unaffected in LBP. Furthermore, moderate
evidence indicated disturbed habituation of somatosensory stimuli in LBP. Most studies examined
nonspecific or mixed CLBP populations, hence EEG-quantified brain activity in (sub)acute or recurrent
LBP still needs to be explored.
Perspective: This review presents an overview of the current understanding of the functional LBP
brain measured with EEG. The limited evidence in current research suggests altered cortical function
regarding balance control, somatosensory processing, and decision making in LBP, and highlights
opportunities for future EEG-research.},
  author       = {Schouppe, Stijn and Van Oosterwijck, Sophie and Danneels, Lieven and Van Damme, Stefaan and Van Oosterwijck, Jessica},
  issn         = {1526-5900},
  journal      = {The Journal of Pain},
  keywords     = {Low back pain,Electroencephalography,Evoked potential,Central nervous system,Neurology,Clinical Neurology},
  language     = {eng},
  title        = {Are Functional Brain Alterations Present in Low Back Pain? A Systematic Review of EEG Studies},
  url          = {http://dx.doi.org/10.1016/j.jpain.2019.06.010},
  year         = {2019},
}

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