{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:41:21Z","timestamp":1790354481005,"version":"4.1.0"},"reference-count":79,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Chronic low back pain (cLBP) poses significant challenges, often addressed through avoidance or distraction. Emerging evidence suggests that mind-body interventions, like our novel Mind Your Pain (MyP) smartphone mobile application, may offer relief. We conducted a single-arm, mixed-methods neuroimaging study to assess the degree to which treatment response to our 8-week intervention, as measured by the reduction in the Pain, Enjoyment of Life and General Activity Scale (PEG), was associated with enhanced pain-related insula activation over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty-nine individuals with cLBP completed patient-reported assessments, qualitative sensory testing (QST) measures, and neuroimaging pre- and post-MyP. Functional MRI data during experimental heat pain on the left forearm were collected and analyzed, comparing responders (\u226550% reduction in PEG scores) and non-responders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>MyP led to significant decreases in PEG scores overall. Furthermore, MyP responders exhibited increased pain-related activation in key brain regions, including the contralateral posterior insula, bilateral ventral anterior insula, ventral anterior cingulate, dorsolateral prefrontal cortex, and nucleus accumbens. Although baseline behavioral and sensory measures did not differ between the two responder groups, baseline neural differences related to the impact of the endogenous back pain were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>MyP appears to modify pain response and underlying neural circuitry, suggesting neural changes in interoception may serve as biomarkers for mind-body interventions in cLBP. This study highlights the potential of MyP as a novel approach for cLBP management, warranting further investigation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpain.2024.1408027","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T05:11:13Z","timestamp":1727673073000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Enhancing chronic low back pain management: an initial neuroimaging study of a mobile interoceptive attention training"],"prefix":"10.3389","volume":"5","author":[{"given":"Irina A.","family":"Strigo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio Garcia","family":"Guerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Torrisi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Murphy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Toor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Goldman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedict J.","family":"Alter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An Thanh","family":"Vu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rich","family":"Hecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Lotz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan N.","family":"Simmons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolf E.","family":"Mehling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1001\/jama.2013.13805","article-title":"The state of US health, 1990\u20132010: burden of diseases, injuries, and risk factors","volume":"310","author":"Murray","year":"2013","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"publisher","first-page":"514","DOI":"10.7326\/M16-2367","article-title":"Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American college of physicians","volume":"166","author":"Qaseem","year":"2017","journal-title":"Ann Intern Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1002\/ejp.931","article-title":"Clinical practice guidelines for the noninvasive management of low back pain: a systematic review by the Ontario protocol for traffic injury management (OPTIMa) collaboration","volume":"21","author":"Wong","year":"2017","journal-title":"Eur J Pain"},{"key":"B4","doi-asserted-by":"publisher","first-page":"469","DOI":"10.20452\/pamw.741","article-title":"2009 Clinical guidelines from the American pain society and the American academy of pain medicine on the use of chronic opioid therapy in chronic noncancer pain: what are the key messages for clinical practice?","volume":"119","author":"Chou","year":"2009","journal-title":"Pol Arch Med Wewn"},{"key":"B5","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.pain.2004.03.034","article-title":"Distraction from chronic pain during a pain-inducing activity is associated with greater post-activity pain","volume":"110","author":"Goubert","year":"2004","journal-title":"Pain"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1472-6882-12-162","article-title":"Mindfulness-based stress reduction for low back pain. 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