Tractographic analysis of proprioceptive and pain pathways in individuals with degenerative scoliosis.

Although increased pain and balance problems in individuals with degenerative scoliosis (DS) are well documented, the associated changes in the central nervous system remain unclear. This study aimed to investigate the impact of postural imbalance and pain in individuals with DS on the central sensory pathways responsible for proprioception and pain modulation. In this context, tractography results of the proprioceptive and pain-modulating pathways were compared between individuals with DS and healthy controls. A total of 38 individuals with DS and 38 healthy individuals were included in the study. Bilateral tractography analyses of relevant pathways were conducted using brain magnetic resonance imaging data and DSI Studio software. Statistical analyses were performed using IBM SPSS 23.0, with P values <.05 considered statistically significant. No significant differences were found between groups in terms of age, weight, height, sex, or BMI (P > .05). Whole-brain average fiber length, mean diffusivity, axial diffusivity, and radial diffusivity values were significantly higher in the DS group compared to the control group (P < .05). Tractography metrics of the lemniscus medialis were significantly lower in individuals with DS (P < .05). In the left reticular formation, average fiber length, fiber volume, fiber area, and fiber proportion values were significantly higher in the DS group (P < .05). In addition, visual analog scale scores for pain were significantly higher in the DS group compared to controls (P < .05). This study demonstrates that increased pain perception and postural imbalance in individuals with DS may be associated with alterations in central sensory pathways, particularly the lemniscus medialis and reticular formation.