{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:59:43Z","timestamp":1785427183101,"version":"3.56.0"},"reference-count":30,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007162","name":"Department of Science and Technology of Guangdong Province","doi-asserted-by":"publisher","award":["2022A0505020019"],"award-info":[{"award-number":["2022A0505020019"]}],"id":[{"id":"10.13039\/501100007162","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007162","name":"Department of Science and Technology of Guangdong Province","doi-asserted-by":"publisher","award":["0056\/2021\/AGJ"],"award-info":[{"award-number":["0056\/2021\/AGJ"]}],"id":[{"id":"10.13039\/501100007162","id-type":"DOI","asserted-by":"publisher"}]},{"award":["2022A0505020019"],"award-info":[{"award-number":["2022A0505020019"]}],"id":[{"id":"https:\/\/ror.org\/00tjzgn92","id-type":"ROR","asserted-by":"publisher"}]},{"award":["0056\/2021\/AGJ"],"award-info":[{"award-number":["0056\/2021\/AGJ"]}],"id":[{"id":"https:\/\/ror.org\/00tjzgn92","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Science and Technology Development Fund of Macau"},{"id":[{"id":"https:\/\/ror.org\/044vr6g03","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Background: Lumbar disc herniation (LDH) is the most common etiological cause of low back pain (LBP). Objective and precise pain evaluation is of significant clinical value. Functional near-infrared spectroscopy (fNIRS) as a noninvasive neuroimaging modality, has been increasingly validated to reflect subjective pain perception through hemodynamic correlates. This study aimed to analyze the fNIRS changes in patients with LDH about to receive Unilateral Biportal Endoscopy and to further explore the feasibility of fNIRS as an objective biomarkers for clinical assessment of LDH. Methods: Resting-state fNIRS data were acquired from 67 preoperative LDH patients and 20 healthy controls (HC). Brain functional maps\u2014including z-standardized fractional amplitude of low-frequency fluctuations (zfALFF) and seed-based functional connectivity (FC)\u2014were extracted and quantified. Group-level comparisons were performed between LDH and HC groups across four predefined regions of interest; additionally, correlation analyses were conducted between fNIRS metrics and clinical assessment scores within the LDH cohort. Results: Compared with HC, LDH patients exhibited significantly altered zfALFF in the medial prefrontal cortex (mPFC): decreased amplitude at channel CH12 (t = \u22122.031, p = 0.045) and increased amplitude at CH21 (t = 2.462, p = 0.016). Whole-brain FC analysis further revealed widespread changes\u2014particularly between the parietal somatosensory cortex and prefrontal regions. Among all tested FC\u2013clinical indicator associations, 56 reached statistical significance after FDR correction (q &lt; 0.05). VAS_ lumbar and SF-36_SF exhibited the highest number of significant connections. Conclusions: LDH patients with LBP exhibit notable alterations in prefrontal resting-state ALFF and FC between the parietal somatosensory cortex and prefrontal cortex relative to HC. Importantly, these neural alterations exhibit significant associations with both pain severity (VAS) and long-term health-related quality of life (SF-36), thereby strengthening their candidacy as neural correlates meriting prospective validation as objective, mechanism-informed biomarkers for clinical evaluation of lumbar disc herniation (LDH). Moreover, these findings highlight candidate neural targets for future longitudinal studies investigating early prognostic prediction and treatment response monitoring in LDH.<\/jats:p>","DOI":"10.3390\/bioengineering13050508","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:43:51Z","timestamp":1777448631000},"page":"508","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["fNIRS as a Biomarker for Preoperative Assessment: Correlating Brain Activity with Clinical Evaluation for Lumbar Disc Herniation"],"prefix":"10.3390","volume":"13","author":[{"given":"Chengjie","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Spinal Surgery, Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changqing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery, Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0355-1129","authenticated-orcid":false,"given":"Zhihai","family":"Su","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macau 999078, China"},{"name":"The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiwei","family":"Guo","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macau 999078, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quan","family":"Wang","sequence":"additional","affiliation":[{"name":"Zhuhai UM Science and Technology Research Institute, University of Macau, Zhuhai 519099, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9527-1142","authenticated-orcid":false,"given":"Tao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery, Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery, Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3061-6263","authenticated-orcid":false,"given":"Zhen","family":"Yuan","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macau 999078, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4212-3282","authenticated-orcid":false,"given":"Hai","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery, Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"ref_1","unstructured":"GBD DAII (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392, 1789\u20131858."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Petersen, T., Laslett, M., and Juhl, C. (2017). Clinical classification in low back pain: Best-evidence diagnostic rules based on systematic reviews. BMC Musculoskel Dis., 18.","DOI":"10.1186\/s12891-017-1549-6"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/S0140-6736(21)00733-9","article-title":"Low back pain","volume":"398","author":"Knezevic","year":"2021","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1016\/j.mayocp.2015.10.009","article-title":"Evaluation and Treatment of Low Back Pain: A Clinically Focused Review for Primary Care Specialists","volume":"90","author":"Hooten","year":"2015","journal-title":"Mayo Clin. Proc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"6362","DOI":"10.1097\/JS9.0000000000002686","article-title":"Impact of first ambulation time on unilateral biportal endoscopy in lumbar disc herniation: A systematic review and meta-analysis","volume":"111","author":"Tang","year":"2025","journal-title":"Int. J. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1530\/EOR-24-0137","article-title":"Unilateral biportal endoscopy: Review and detailed surgical approach to extraforaminal approach","volume":"10","author":"Reis","year":"2025","journal-title":"EFORT Open Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S29","DOI":"10.1016\/j.pain.2013.09.001","article-title":"Pain matrices and neuropathic pain matrices: A review","volume":"154","author":"Peyron","year":"2013","journal-title":"Pain"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"N24","DOI":"10.1227\/01.neu.0000432627.18847.8e","article-title":"Can pain be measured objectively?","volume":"73","author":"Lu","year":"2013","journal-title":"Neurosurgery"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1056\/NEJMoa1204471","article-title":"An fMRI-based neurologic signature of physical pain","volume":"368","author":"Wager","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"101767","DOI":"10.1016\/j.arr.2022.101767","article-title":"Potential mechanisms underlying the accelerated cognitive decline in people with chronic low back pain: A scoping review","volume":"82","author":"Zhou","year":"2022","journal-title":"Ageing Res. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Chen, W., Wagner, J., Heugel, N., Sugar, J., Lee, Y., Conant, L., Malloy, M., Heffernan, J., Quirk, B., and Zinos, A. (2020). Functional Near-Infrared Spectroscopy and Its Clinical Application in the Field of Neuroscience: Advances and Future Directions. Front. Neurosci., 14.","DOI":"10.3389\/fnins.2020.00724"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"119351","DOI":"10.1016\/j.neuroimage.2022.119351","article-title":"Resting-state electroencephalography (EEG) biomarkers of chronic neuropathic pain. A systematic review","volume":"258","author":"Mussigmann","year":"2022","journal-title":"Neuroimage"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s40168-023-01717-5","article-title":"The fusion of multi-omics profile and multimodal EEG data contributes to the personalized diagnostic strategy for neurocognitive disorders","volume":"12","author":"Han","year":"2024","journal-title":"Microbiome"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2894","DOI":"10.1097\/j.pain.0000000000002281","article-title":"Dynamics of brain function in patients with chronic pain assessed by microstate analysis of resting-state electroencephalography","volume":"162","author":"May","year":"2021","journal-title":"Pain"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.neubiorev.2020.10.023","article-title":"NIRS measures in pain and analgesia: Fundamentals, features, and function","volume":"120","author":"Karunakaran","year":"2021","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Li, R., Shao, W., Zhao, S., Wang, L., Yu, C., Liu, L., and Yin, K. (2025). EEG alpha\/beta features as a biomarker for quantifying pain in patients with lumbar disk herniation. Front. Neurosci., 19.","DOI":"10.3389\/fnins.2025.1507245"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"20901","DOI":"10.1117\/1.NPh.10.2.020901","article-title":"Behavioral modeling and neuroimaging of impaired risky decision making in patients with chronic musculoskeletal pain","volume":"10","author":"Zeng","year":"2023","journal-title":"Neurophotonics"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"101784","DOI":"10.1016\/j.xcrm.2024.101784","article-title":"Advances and challenges in neuroimaging-based pain biomarkers","volume":"5","author":"Zhang","year":"2024","journal-title":"Cell Rep. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"10802","DOI":"10.1117\/1.NPh.8.1.010802","article-title":"NIRS-KIT: A MATLAB toolbox for both resting-state and task fNIRS data analysis","volume":"8","author":"Hou","year":"2021","journal-title":"Neurophotonics"},{"key":"ref_20","first-page":"661","article-title":"Cortical functional mechanism of impaired postural control in patients with chronic low back pain: A fNIRS study","volume":"40","author":"Wang","year":"2025","journal-title":"Chin. J. Rehabil. Med."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Zeng, X., Tang, W., Yang, J., Lin, X., Du, M., Chen, X., Yuan, Z., Zhang, Z., and Chen, Z. (2023). Diagnosis of Chronic Musculoskeletal Pain by Using Functional Near-Infrared Spectroscopy and Machine Learning. Bioengineering, 10.","DOI":"10.3390\/bioengineering10060669"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e2556647","DOI":"10.1001\/jamanetworkopen.2025.56647","article-title":"Detection of \u03949-Tetrahydrocannabinol Impairment Using Resting-State Functional Near-Infrared Spectroscopy: A Randomized Clinical Trial","volume":"9","author":"Berchansky","year":"2026","journal-title":"JAMA Netw. Open"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.brs.2024.04.019","article-title":"The effect of tDCS on inhibitory control and its transfer effect on sustained attention in children with autism spectrum disorder: An fNIRS study","volume":"17","author":"Chen","year":"2024","journal-title":"Brain Stimul."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2688","DOI":"10.1109\/TNSRE.2024.3429337","article-title":"fNIRS-Driven Depression Recognition Based on Cross-Modal Data Augmentation","volume":"32","author":"Shao","year":"2024","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1038\/s41398-025-03224-7","article-title":"Application of functional near-infrared spectroscopy and machine learning to predict treatment response after six months in major depressive disorder","volume":"15","author":"Ho","year":"2025","journal-title":"Transl. Psychiat"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"103355","DOI":"10.1016\/j.compbiomed.2019.103355","article-title":"Prediction of epileptic seizures with convolutional neural networks and functional near-infrared spectroscopy signals","volume":"111","author":"Guevara","year":"2019","journal-title":"Comput. Biol. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"104255","DOI":"10.1016\/j.ebiom.2022.104255","article-title":"Evolution of brain functional plasticity associated with increasing symptom severity in degenerative cervical myelopathy","volume":"84","author":"Wang","year":"2022","journal-title":"eBioMedicine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3356","DOI":"10.1109\/JBHI.2025.3527074","article-title":"Short-Term Longitudinal Study on Brain Network Informatics of Stroke Patients Under Acupuncture and Motor Imagery Intervention","volume":"29","author":"Qu","year":"2025","journal-title":"IEEE J. Biomed. Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/S0926-6410(97)00016-5","article-title":"Loss of functional hemispheric asymmetry in Alzheimer\u2019s dementia assessed with near-infrared spectroscopy","volume":"6","author":"Fallgatter","year":"1997","journal-title":"Brain Res. Cogn. Brain Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5170","DOI":"10.1002\/alz.13897","article-title":"fNIRS as a biomarker for individuals with subjective memory complaints and MCI","volume":"20","author":"Lee","year":"2024","journal-title":"Alzheimer\u2019s Dement. J. Alzheimer\u2019s Assoc."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/5\/508\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T09:06:43Z","timestamp":1777453603000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/5\/508"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,28]]},"references-count":30,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["bioengineering13050508"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering13050508","relation":{},"ISSN":["2306-5354"],"issn-type":[{"value":"2306-5354","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,28]]}}}