# Cortical Mapping of Neuropathic Low Back Pain

> **NIH NIH R21** · UNIVERSITY OF ROCHESTER · 2020 · $192,500

## Abstract

PROJECT SUMMARY:
 Chronic low-back pain (CLBP) is a disabling condition with no available cure. About 30% of CLBP patients
suffer from neuropathic back pain, which is thought to arise from an injury to the nerve root secondary to
degenerated discs and/or local inflammation. Compared to CLBP without a neuropathic component, neuropathic
CLBP is associated with more patient distress, especially in women, increased severity of medical co-morbidities
and a 70% increase in health care cost. Despite extensive pre-clinical studies of peripheral nerve injury pain
models and clinical research on neuropathic CLBP there is no effective analgesic treatment to date. This state
of affair reflects our limited understanding of the pathophysiology of neuropathic CLBP and the need for novel
targets for analgesic treatment. Accumulating evidence point to a critical role of the brain limbic and
somatosensory circuitries in the pathophysiology of chronic pain in humans. Our pilot data is among the first to
show smaller thalamus and altered thalamic and limbic system functional connectivity in neuropathic CLBP
compared to non-neuropathic CLBP patients and healthy controls. Regardless, systematic mapping of these
circuitries in neuropathic CLBP pain patients is still lacking. The objective of the study is to map structural and
functional properties of the limbic and somatosensory circuitries in neuropathic CLBP in comparison to non-
neuropathic CLBP patients and matched healthy controls. We hypothesize that neuropathic CLBP patients will
show significant structural and functional alterations in the brain somatosensory system.
 Brain structural and functional measures and behavioral measures will be collected in 3 study groups:
(1) neuropathic CLBP patients (2) non-neuropathic CLBP patients and (3) matched healthy control participants.
CLBP patients will be classified as neuropathic or non-neuropathic in a two-step process based on a validated
questionnaire (PainDETECT) and a standardized evaluation of pain tool, which combines sensory testing and
validated questions targeting neuropathic pain symptoms. All participants will undergo functional brain imaging
to collect resting state brain activity and structural brain images. Sub-cortical brain volumes, cortical thickness,
white matter connectivity and functional connectivity will be compared among the three groups. In Aim 1, we will
use fMRI to study brain functional and structural differences between neuropathic CLBP, non-neuropathic CLBP
and healthy matched controls. In Aim 2, we will explore sex differences in brain structure and function in
neuropathic CLBP patients, compared to non-neuropathic CLBP and healthy controls. Our long-term goal is to
use the brain biomarkers of neuropathic CLBP derived from this proposal for future validation studies across
sites, and for developing novel therapeutic targets both in humans and in animal models.

## Key facts

- **NIH application ID:** 10040696
- **Project number:** 1R21NS118162-01
- **Recipient organization:** UNIVERSITY OF ROCHESTER
- **Principal Investigator:** Paul Geha
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $192,500
- **Award type:** 1
- **Project period:** 2020-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10040696

## Citation

> US National Institutes of Health, RePORTER application 10040696, Cortical Mapping of Neuropathic Low Back Pain (1R21NS118162-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10040696. Licensed CC0.

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