THE ASSOCIATION BETWEEN PRO-INFLAMMATORY CYTOKINES, MRI FINDINGS AND QUANTITATIVE SENSORY TESTING IN PATIENTS WITH SCIATICA
Bibliographic record
Abstract
Background: The mechanisms of sciatica are thought to be associated with nerve root compression and inflammation, causing neuropathic pain and disability. Several pro inflammatory cytokines have been suggested as promotors of disc herniations and pain. Additionally, microbial pathogens have also been associated with disc herniations and sciatica. Despite the frequent occurrence of sciatica in the general population its underling mechanisms are obscure. Therefore, we aimed to assess the clinical manifestations and sensory profiles of patients with sciatica, and their relationship to disc microbial infection, levels of disc and blood cytokines, herniation size and location, and pain-related psychological factors.Methods: Fifty-three adult subjects scheduled for lumbar spine surgery due to radicular pain were evaluated using experimental sensory tests (heat, cold and mechanical detection and pain thresholds, temporal summation and conditioned pain modulation(CPM)), Oswestry Low Back Pain Disability Index (ODI), Short-Form McGill Pain Questionnaire (SF-MPQ), Spielberger's Sate-Trait Anxiety Inventory (STAI), Pain Sensitivity Questionnaire (PSQ), Pain Catastrophizing Scale (PCS), DN4 questionnaire and neurological examination prior to surgery. Subjects' blood and disc samples were tested for levels of pro-inflammatory cytokines (interleukin (IL)-1b, IL-6, IL-8, IL-17, tumor necrosis factor alpha (TNFa) and interferon gamma (IFNg)) and microbial infections using ELISA and rt-PCT. Subjects' MRI scans were assessed for disc herniation size and place using the MSU classification and three-dimensional volumetric analysis.Results: Complete data was available from 40 (75%) patients (15 female) age 44.8u00b116.3 years. Clinical pain (r=0.429, P=0.007) and SF-MPQ (r=0.459, P=0.003) were positively correlated with pain catastrophizing and negatively correlated to CPM (r=-0.437, P=0.006; r=-0.421, P=0.007; for average pain and affective SF-MPQ respectively). ODI was positively correlated with pain ratings (r=0.441, P=0.006) and SF-MPQ (r=0.635, P<0.001) and negatively correlated with painful leg strength (r=-0.358, P=0.023) and CPM (r=-0.369, P=0.019). No correlations were found between pain and disability with MRI assessments, disc and blood cytokine levels and bacterial infection.Conclusion: Psychological factors and pain modulation capacity are more prone to influence pain in patients with sciatica than objective measures of inflammation and imaging findings. Disability in these patients are more likely due to pain intensity and quality than inflammation and imaging findings. The role of mechanical compression and inflammation in the development and maintenance of sciatica pain is still obscure and awaits further research.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".