Patterns of Muscle Health in Single- and Multi-Site Chronic Pain: A UK Biobank Normative Modeling Study

作者：Merve Kaptan, Yiyu Wang, Augustijn A. A. de Boer, Ananya Goyal, Skylar C. Holmes, K. Ozkan, Sandrine Bédard, Teresa Indriolo, Christine S W Law, Dario Pfyffer, Joel Fundaun, Estifanos Berhe, Garry E. Gold, A.S. Chaudhari, Anoosha Pai S, Anthony A. Gatti, Feliks Kogan, Brian A. Hargreaves, Scott L. Delp, John K. Ratliff, Serena Hu, Anand Veeravagu, Atman Desai, Suzanne Tharin, Todd Alamin, Andrew C. Smith, Marnee J. McKay, Brian Kim, Robert Walsh, Alec Schielke, Dean Dennis, Johannes H. Decker, Benjamin De Leener, Julien Cohen‐Adad, Zachary A. Smith, F. Muhammad, James M. Elliott, André F. Marquand, Sean Mackey, Evert Onno Wesselink, Kenneth A. Weber · 发表于：medRxiv · 年份：2026 · DOI：10.64898/2026.06.19.26356062 · 研究领域：Musculoskeletal pain and rehabilitation、Pain Mechanisms and Treatments、Fibromyalgia and Chronic Fatigue Syndrome Research

Background: Chronic pain is associated with impaired muscle health, but whether these changes reflect site-specific factors, broader systemic factors, or both remains unclear. The purpose of this study is to determine whether normative markers of muscle health derived from MRI show site-specific patterns in chronic pain. Methods: UK Biobank participants who underwent whole-body MRI from 2006 to 2010 were included in this retrospective cross-sectional study. The MuscleMap Toolbox quantified volume and intramuscular fat (IMF) in 42 muscles of the abdomen, pelvis, and thigh. Normative models trained on a no pain group generated muscle-specific deviations from normal (i.e., Z-scores) for single- and multi-site chronic and acute pain. Results: Of 17,843 participants, the primary site-specific analysis included 9,704 no pain, 885 single-site chronic back pain (CBP), 438 single-site chronic hip pain (CHP), and 1,315 single-site chronic knee pain (CKP) participants (n=12,342; mean age 63.7±7.5 years; 52.7% female). Additional analyses included single-site chronic neck/shoulder pain, acute pain, and multi-site chronic pain groups. In CBP, deviations were localized to abdominal muscles, with decreased volume in 6/8 and increased IMF in 6/8. In CHP, deviations were broad, with decreased volume in 3/8 of the abdominal and 14/26 of the thigh muscles, and increased IMF in 6/8 of the abdominal, 5/8 of the pelvic, and 4/26 of the thigh muscles. In CKP, deviations were localized to thigh musc...