TUESDAY, March 10, 2026 (HealthDay News) -- Chronic back pain (CBP) is associated with pronounced auditory hyperresponsivity via modality-specific and modality-general neural pathways, according to a study published online Feb. 27 in the Annals of Neurology.
Alina E.C. Panzel, from the University Medical Center Hamburg-Eppendorf in Germany, and colleagues compared behavioral and neural responses to auditory and pressure stimulation in 142 adults with CBP and 51 pain-free controls. Patients with CBP entered a randomized trial of pain reprocessing therapy (PRT) compared with placebo and usual care. Participants experienced low- and high-intensity aversive sounds and mechanical pressure during functional magnetic resonance imaging and provided unpleasantness ratings.
The researchers found that compared with healthy controls, patients with CBP reported heightened unpleasantness to auditory stimuli and mechanical pressure (Hedges' g = 0.95 to 1.03 and 0.49 to 0.66, respectively). Auditory stimulation revealed primary auditory cortex and insula hyperresponsivity, hyporesponsivity in the precuneus and medial prefrontal cortex (g = 0.33 to 0.59), and increased expression of generalized and auditory-specific aversive processing patterns (g = 0.33 to 0.39) and fibromyalgia-derived multisensory sensitivity patterns (g = 0.43 to 0.50) in patients versus controls. Reduced unpleasantness of low-intensity auditory stimulation was seen with PRT versus placebo in a longitudinal analysis, along with increased medial prefrontal cortex responses for PRT versus usual care.
"These findings add to growing evidence that chronic back pain is not just a problem in the back, the brain plays a central role in driving chronic pain, by amplifying a range of sensations -- sensory signals from the back, sounds, and likely other sensations as well," senior author Yoni K. Ashar, Ph.D., from the University of Colorado Anschutz Medical Campus in Aurora, said in a statement.
One author received consulting fees from the Pain Reprocessing Therapy Center, Lin Health, and Mental Health Partners of Boulder County.