The neural oscillations of chronic low back pain

Pain. 2026 May 6. doi: 10.1097/j.pain.0000000000003975. Online ahead of print.

ABSTRACT

Chronic low back pain (cLBP) is associated with fear-related behavioral adaptations and changes in brain function, but the spatial location and frequency of resting neural oscillations that underlie cLBP are not well-understood. In this study we used 128-channel resting-state electroencephalography in older adults with cLBP and high fear, cLBP and low fear, and healthy controls to close this critical gap. Source-space analyses and the Fitting Oscillations and One Over F algorithm were implemented to decompose resting electroencephalography spectra into periodic and aperiodic components. We offer 2 novel contributions to the literature. First, periodic alpha power was lower in the high fear group in temporal and occipital regions compared with the control group and the low fear group. Second, a progressive decrease in periodic beta power was evident across groups in temporal, parietal, and occipital regions, with the lowest power in the high fear group and greatest in the control group. Aperiodic components were not different between groups. Our findings suggest that the neurophysiological signature of cLBP is distinct from that observed in other chronic pain conditions and from a pattern of accelerated aging. Indeed, too little or too much beta power at rest may equally represent suboptimal neural function. Our findings advance our understanding of the neural oscillations that underlie cLBP, but also further highlight the complexity of identifying a single and generalizable neural signature of chronic pain.

PMID:42153470 | DOI:10.1097/j.pain.0000000000003975