Current source density and functional connectivity extracted from resting-state electroencephalography as biomarkers for chronic low back pain.

Introduction: Chronic low back pain (CLBP) is a global health issue, and its nonspecific causes make treatment challenging. Understanding the neural mechanisms of CLBP should contribute to developing effective therapies.

Objectives: To compare current source density (CSD) and functional connectivity (FC) extracted from resting electroencephalography (EEG) between patients with CLBP and healthy controls and to examine the correlations between EEG indices and symptoms.

Methods: Thirty-four patients with CLBP and 34 healthy controls in an open data set were analyzed. Five-minute resting-state closed-eye EEG was acquired using the international 10-20 system. Current source density across frequency bands was calculated using exact low-resolution electromagnetic tomography. Functional connectivity was assessed between 24 cortical regions using lagged linear connectivity. Correlations between pain symptoms and CSD distribution and FC were examined in patients with CLBP.

Results: Current source density analysis showed no significant differences between the groups. The CLBP group exhibited significantly reduced FC in the β3 band between the left middle temporal gyrus and the posterior cingulate cortex, and between the ventral medial prefrontal cortex and the left inferior parietal lobule. Prefrontal θ and δ activity positively correlated with pain symptoms. Increased β1 band FC between the right dorsolateral prefrontal cortex and right auditory cortex correlated with greater pain intensity.

Conclusions: We found altered neural activity and connectivity in patients with CLBP, particularly in prefrontal and temporal regions. These results suggest potential targets for pain modulation through brain pathways and highlight the value of EEG biomarkers in understanding pain mechanisms and assessing treatment efficacy.