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Ageing research reviews. 2022 Oct 21. pii: S1568-1637(22)00209-4. doi: 10.1016/j.arr.2022.101767

Potential mechanisms underlying the accelerated cognitive decline in people with chronic low back pain: A scoping review.

Zhou Z¹, Hui ES², Kranz GS³, Chang JR⁴, de Luca K⁵, Pinto SM⁶, Chan WW⁷, Yau SY⁸, Chau BK⁹, Samartzis D¹⁰, Jensen MP¹¹, Wong AYL¹²

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¹Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong SAR, China.
²Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong SAR, China.
³Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong SAR, China; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China.
⁴Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong SAR, China.
⁵School of Health, Central Queensland University, Brisbane, Australia.
⁶Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong SAR, China.
⁷Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong SAR, China.
⁸Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong SAR, China; Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
⁹Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong SAR, China.
¹⁰Department of Orthopedic Surgery, Rush University Medical Centre, Chicago, IL, USA.
¹¹Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
¹²Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong SAR, China; Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China. Electronic address: arnold.wong@polyu.edu.hk.

Abstract

A growing body of evidence has shown that people with chronic low back pain (CLBP) demonstrate significantly greater declines in multiple cognitive domains than people who do not have CLBP. Given the high prevalence of CLBP in the ever-growing aging population that may be more vulnerable to cognitive decline, it is important to understand the mechanisms underlying the accelerated cognitive decline observed in this population, so that proper preventive or treatment approaches can be developed and implemented. The current scoping review summarizes what is known regarding the potential mechanisms underlying suboptimal cognitive performance and cognitive decline in people with CLBP and discusses future research directions. Five potential mechanisms were identified based on the findings from 34 included studies: (1) altered activity in the cortex and neural networks; (2) grey matter atrophy; (3) microglial activation and neuroinflammation; (4) comorbidities associated with CLBP; and (5) gut microbiota dysbiosis. Future studies should deepen the understanding of mechanisms underlying this association so that proper prevention and treatment strategies can be developed.

KEYWORDS: Chronic low back pain, Cognitive decline, Default mode network, Dorsal lateral prefrontal cortex, Medial prefrontal cortex, Neuroinflammation

Publikations ID: 36280211
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