Lombalgia Cronica Aspecifica e Superfici Percettive: Rappresentazione Corticale Del Tronco Nella Risposta al Trattamento Riabilitativo - Studio Quasi-sperimentale Non Randomizzato
Trial Snapshot
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Enrollment
- 40
- Locations
- 1
Study Overview
Brief Summary
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.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Basic Science
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 45 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
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
Arms & Interventions
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.
Intervention: Perceptive Surface (SU-PER mat) (Device)
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.
Intervention: Perceptive Surface (SU-PER mat) (Device)
Investigators
Teresa Paolucci
Associate Professor
G. d'Annunzio University