Brain Effect Mechanism of Lever Positioning Manipulation on LDH Analgesia Based on Multimodal fMRI and MRS

• Status: Active, not recruiting
• Trial end date: 2025-09-01
• Target enrollment: 0
• Participant gender: All

Summary

In the early stage, two previous studies supported by the National Natural Science Foundation of China revealed the biomechanical characteristics and neural feedback mechanism of lever positioning manipulation on lumbar intervertebral disc. In order to further explore the analgesic brain effect mechanism of lever positioning manipulation on lumbar disc herniation (LDH), the pre experiments were conducted and the results showed that lever positioning manipulation had significant specific brain network effect before and after the intervention of LDH. In order to deeply research the key brain targets and central response mechanism characteristics of analgesia, this study, with the dominant diseases of LDH as the object, is divided into manipulation group, drug group and healthy subject group. Multimodal fMRI and Mrs scanning imaging techniques are used to compare the low-frequency amplitude (mfalff) and local consistency (ReHo) of each group, and analyze the local brain function connection characteristics of the brain areas related to pain matrix as seed points. Then independent component analysis (ICA) was used to explore the functional connection of the whole brain network, and the signals of related metabolites glutamate (Glu) and 1-aminobutyric acid (GABA) in the brain were detected, in order to clarify the network regulation of lever positioning manipulation on the analgesic brain effect of LDH and the biochemical mechanism of central nerve, so as to provide a modern biological basis for the clinical application of lever positioning manipulation on LDH.

• Phase: N/A
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: The Third Affiliated hospital of Zhejiang Chinese Medical University
• Treatments: Analgesics; Ibuprofen

Criteria

Inclusion Criteria:

1. patients suffering from low back pain and/or radicular leg pain;

2. persistent pain for at least six months that was nonresponsive to conservative treatments;

3. at least one epidural or facet joint corticosteroid injection in the last past year without pain relief or with an improvement in pain of less than two months.

4. Lumbar protrusion level discopathy on MRI corresponding to the level of pain.

5. No interventional pain treatment was applied within the last three months and patients needed a pain score equal or greater than four on the visual analogic scale (VAS).

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Exclusion Criteria:

1.patients with motor deficits, systemic infection, coagulation disorders, pregnancy； 2.VAS pain score lower than four； 3.Patients with any other condition that prevents an MRI scan from being performed.

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