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Changes in brain motor areas have been observed and suggested as a mechanism underlying spine movement alteration. Nociceptive withdrawal reflex (NWR) might be used to test spinal networks involved in trunk protection and to highlight reorganization. This study aimed to determine whether the organization and excitability of the trunk NWR are modified in CLBP. We hypothesized that individuals with CLBP would have modified NWR patterns and lower NWR thresholds. Noxious electrical stimuli were delivered over S1, L3 and T12, and the 8<jats:sup>th<\/jats:sup> Rib to elicit NWR in 12 individuals with and 13 individuals without CLBP. EMG amplitude and occurrence of <jats:italic>lumbar multifidus<\/jats:italic> (LM), <jats:italic>thoracic erector spinae<\/jats:italic>, <jats:italic>rectus abdominus<\/jats:italic>, <jats:italic>obliquus internus<\/jats:italic> and <jats:italic>obliquus externus<\/jats:italic> motor responses were recorded using surface electrodes. Two different patterns of responses to noxious stimuli were identified in CLBP compared to controls: (i) abdominal muscle NWR responses were generally more frequent following 8<jats:sup>th<\/jats:sup> rib stimulation and (ii) occurrence of erector spinae NWR was less frequent. In addition, we observed a subgroup of participants with very high NWR threshold in conjunction with the larger abdominal muscle responses. These results suggest sensitization of NWR is not present in all individuals with CLBP, and a modified organization in the spinal networks controlling the trunk muscles that might explain some changes in spine motor control observed in CLBP.<\/jats:p>","DOI":"10.1371\/journal.pone.0286786","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T17:34:26Z","timestamp":1686764066000},"page":"e0286786","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Nociceptive withdrawal reflexes of the trunk muscles in chronic low back pain"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4472-9656","authenticated-orcid":true,"given":"Hugo","family":"Mass\u00e9-Alarie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevieve V.","family":"Hamer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7616-9003","authenticated-orcid":true,"given":"Sauro E.","family":"Salomoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1206-9107","authenticated-orcid":true,"given":"Paul W.","family":"Hodges","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,6,14]]},"reference":[{"issue":"11","key":"pone.0286786.ref001","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.jpain.2005.06.008","article-title":"A meta-analytic review of surface electromyography among persons with low back pain and normal, healthy controls.","volume":"6","author":"ME Geisser","year":"2005","journal-title":"J Pain."},{"key":"pone.0286786.ref002","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.jelekin.2016.02.004","article-title":"Influence of chronic low back pain and fear of movement on the activation of the transversely oriented abdominal muscles during forward bending","volume":"27","author":"H Mass\u00e9-Alarie","year":"2016","journal-title":"J Electromyogr Kinesiol"},{"issue":"3","key":"pone.0286786.ref003","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.pain.2008.12.002","article-title":"Why do some patients keep hurting their back? 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