Brain Connectivity and Perceptive Surfaces in Chronic Low Back Pain (SUPER-RMNf)
Lombalgia Cronica Aspecifica e Superfici Percettive: Rappresentazione Corticale Del Tronco Nella Risposta al Trattamento Riabilitativo - Studio Quasi-sperimentale Non Randomizzato
Rationale:
Chronic Low Back Pain (CLBP) is often associated with "cortical reorganization," where the brain's map of the back becomes less precise. This phenomenon contributes to the persistence of pain and reduced body awareness. While traditional rehabilitation focuses on the physical structure of the spine, neurocognitive approaches use "perceptive surfaces" to provide specific tactile and proprioceptive feedback, aiming to "retrain" the brain's representation of the trunk.
Objective and Hypothesis:
The primary goal of this study is to investigate how the brain responds to stimulation from these perceptive surfaces in patients with CLBP compared to healthy individuals. The investigators hypothesize that using these surfaces will lead to immediate changes in functional brain connectivity, particularly in areas responsible for body awareness and pain processing (somatosensory and salience networks).
Study Procedures:
The study will involve 20 patients with chronic non-specific low back pain and 20 healthy volunteers. All participants will undergo a Functional Magnetic Resonance Imaging (fMRI) session. During the scan, participants will be placed on a specialized perceptive surface. Brain activity and connectivity will be measured at rest and during specific tactile stimulation. Additionally, advanced imaging techniques (SANDI model) will be used to look at the microscopic structure of brain cells (neurons).
Clinical Impact:
By comparing the two groups, the study aims to identify specific "brain signatures" of recovery. This could help clinical professionals understand if perceptive surfaces can effectively restore cortical maps, leading to better personalized rehabilitation strategies for chronic pain.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Studietyp
Inskrivning (Beräknad)
Fas
- Inte tillämpbar
Kontakter och platser
Studiekontakt
- Namn: Teresa Paolucci
- Telefonnummer: +39 3278588219
- E-post: teresa.paolucci@unich.it
Studieorter
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Chieti (CH)
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Chieti, Chieti (CH), Italien, 66100
- ITAB - Istituto di Tecnologie Avanzate Biomediche - Università degli Studi "G. d'Annunzio"
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Kontakt:
- Teresa Paolucci
- Telefonnummer: +39 3278588219
- E-post: teresa.paolucci@unich.it
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
Tar emot friska volontärer
Beskrivning
Inclusion Criteria:
- Aged between 18 and 45 years
- Right-handed dominance
- Good general health condition
- Ability to provide written informed consent.
For the patient group:
- Clinical diagnosis of non-specific chronic low back pain with a duration of more than 3 months
For the control group:
- Healthy volunteers without a history of chronic pain
Exclusion Criteria:
- Contraindications to 3T Magnetic Resonance Imaging, such as pacemakers or non-compatible metallic implants
- Pregnancy or breastfeeding
- Presence of significant neurological or psychiatric pathologies
- Current use of psychoactive medications.
- Sensory or motor disorders of the lower limbs that prevent interaction with the perceptive surface.
- Unstable or acute clinical conditions.
- Inability to remain still during the MRI scanning procedure
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Grundläggande vetenskap
- Tilldelning: Icke-randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: CLBP Patients
This arm includes 20 participants with a clinical diagnosis of non-specific chronic low back pain (duration > 3 months). Participants undergo a clinical and functional evaluation through validated scales (VAS, RMDQ, MPQ, Waddell Index, Zung SAS/SDS, BAQ). The experimental procedure consists of a 3T MRI session including two resting-state fMRI blocks: one in a neutral condition and one while interacting with a "perceptive surface" (postural mat with sensory cones). Advanced microstructural imaging (SANDI model) is also performed. |
The intervention consists of a postural mat equipped with sensory cones of varying elastic memory and elasticity. This tool is used as a neurocognitive rehabilitation device designed to restore body perception and postural control. The device is passive, non-magnetic, and made of MRI-compatible latex (inert material). During the fMRI session, the surface is positioned so that the participant, while lying in the scanner, perceives specific plantar or trunk tactile and proprioceptive stimuli. |
|
Aktiv komparator: Healthy Controls
This arm includes 20 healthy volunteers, aged 18-45, without history of chronic pain. Participants undergo the same 3T MRI protocol as the clinical group (neutral vs. perceptive surface conditions) to provide a baseline for "normal" cortical representation and connectivity. Clinical evaluations for this group are limited to demographic data and the Visual Analogue Scale (VAS) for pain/discomfort monitoring during the scan. |
The intervention consists of a postural mat equipped with sensory cones of varying elastic memory and elasticity. This tool is used as a neurocognitive rehabilitation device designed to restore body perception and postural control. The device is passive, non-magnetic, and made of MRI-compatible latex (inert material). During the fMRI session, the surface is positioned so that the participant, while lying in the scanner, perceives specific plantar or trunk tactile and proprioceptive stimuli. |
Vad mäter studien?
Primära resultatmått
Resultatmått |
Tidsram |
|---|---|
|
Functional Connectivity Changes in Somatosensory and Salience Networks
Tidsram: Periprocedural
|
Periprocedural
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Neuronal Microstructure Mapping (SANDI model)
Tidsram: Periprocedural
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Periprocedural
|
|
|
Acute Pain Perception (Visual Analogue Scale)
Tidsram: Day 1
|
Minimum Value: 0 Maximum Value: 10 Higher scores mean a worse outcome
|
Day 1
|
|
Functional Disability in CLBP Patients (Roland Morris Disability Questionnaire)
Tidsram: Day 1
|
Minimum Value: 0 Maximum Value: 24 Higher scores mean a worse outcome
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Day 1
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Andra resultatmått
Resultatmått |
Tidsram |
|---|---|
|
Brainstem Connectivity (PAG)
Tidsram: Periprocedural
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Periprocedural
|
Samarbetspartners och utredare
Sponsor
Studieavstämningsdatum
Studera stora datum
Studiestart (Beräknad)
Primärt slutförande (Beräknad)
Avslutad studie (Beräknad)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- SUPER-RMNf
- 447 (Annan identifierare: Comitato Etico Regione Abruzzo (Submission ID))
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