Neural correlates of fear of movement in high and low fear-avoidant chronic low back pain patients: An event-related fMRI study.

The fear-avoidance model postulates that in chronic low back pain (CLBP) a fear of movement is acquired in the acute phase, which leads to subsequent avoidance of physical activity and contributes to the pain syndromeʼs becoming chronic. In the present event-related functional magnetic resonance imaging (fMRI) study of the neural correlates of the fear of movement, 60 women (30 CLBP patients, 15 healthy controls, and 15 women with spider phobia; mean age 46.8 ± 9.8 years) participated. The CLBP patients were divided into a high and low fear-avoidant group on the basis of the Tampa Scale of Kinesiophobia. The participants viewed photographs depicting neutral and aversive (back-stressing) movements, generally fear-inducing and neutral pictures from the International Affective Picture System, and pictures of spiders while fMRI data were acquired. It was hypothesized that the high fear-avoidant CLBP patients would show fear-related activations when viewing the aversive movements and that they would differ from CLBP patients with low fear-avoidance and controls in this regard. No such activations were found for high or low fear-avoidant CLBP patients. The random-effects analysis showed no differences between high and low fear-avoidant CLBP patients or high fear-avoidant CLBP patients and controls. Normal fear-related activations were present in the high fear-avoidant CLBP patients for the generally fear-inducing pictures, demonstrating the validity of the stimulation paradigm and a generally unimpaired fear processing of the high fear-avoidant CLBP patients. Our findings do not support the fear component of the fear avoidance model. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Accession Number: 2012-04705-011. PMID: 22230805 Partial author list: First Author & Affiliation: Barke, Antonia; Georg-Elias-Muller-Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Gottingen, Gottingen, Germany. Other Publishers: Lippincott Williams & Wilkins. Release Date: 20120430. Correction Date: 20160421. Publication Type: Journal (0100), Peer Reviewed Journal (0110). Format Covered: Electronic. Document Type: Journal Article. Language: English. Major Descriptor: Back Pain; Chronic Pain; Fear; Neurology; Phobias. Classification: Physical & Somatoform & Psychogenic Disorders (3290). Population: Human (10); Female (40). Age Group: Adulthood (18 yrs & older) (300). Tests & Measures: Tampa Scale of Kinesiophobia; Pain Disability Index-German Version; Pain Catastrophising Scale-German Version; Fear Avoidance Beliefs Questionnaire-German Version; Fear of Spider Questionnaire-German Version; State Trait Anxiety Inventory; Structured Clinical Interview for DSM-IV Axis I Disorders; Center for Epidemiologic Studies Depression Scale. Methodology: Brain Imaging; Empirical Study; Interview; Quantitative Study. Supplemental Data: Appendixes Internet. References Available: Y. Page Count: 13. Issue Publication Date: Mar, 2012. Publication History: Accepted Date: Nov 8, 2011; Revised Date: Sep 8, 2011; First Submitted Date: Mar 8, 2011. Copyright Statement: All rights reserved. International Association for the Study of Pain. 2011.