Evidence map›Paper›PMID 41356067›Full record

ArticleArXiv2025

LAYER: A Quantitative Explainable AI Framework for Decoding Tissue-Layer Drivers of Myofascial Low Back Pain.

Zixue Zeng, Anthony M Perti, Tong Yu, Grant Kokenberger, Hao-En Lu, Jing Wang, Xin Meng, Zhiyu Sheng, Maryam Satarpour, John M Cormack and 6 more

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In one paragraph

Article in ArXiv, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Zixue ZengDepartment of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Anthony M PertiDepartment of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Tong YuDepartment of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Grant KokenbergerDepartment of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Hao-En LuDepartment of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Jing WangDepartment of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Xin MengDepartment of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Zhiyu ShengCardiology, Department of Medicine, University of Pittsburgh, PA 15213, USA.
Maryam SatarpourDepartment of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA.
John M CormackCardiology, Department of Medicine, University of Pittsburgh, PA 15213, USA.
Allison C BeanDepartment of Physiatry, University of Pittsburgh School of Medicine, PA 15213, USA.
Ryan P NussbaumDepartment of Physiatry, University of Pittsburgh School of Medicine, PA 15213, USA.
Emily Landis-WalkenhorstDepartment of Anesthesiology & Perioperative Medicine, University of Pittsburgh, School of Medicine, PA 15213, USA.
Kang KimDepartment of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Ajay D WasanDepartment of Anesthesiology & Perioperative Medicine, University of Pittsburgh, School of Medicine, PA 15213, USA.
Jiantao PuDepartment of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA.

Funding

Development and Validation of a Multimodal Ultrasound- Based Biomarker for Myofascial PainR61AT012282 · NCCIH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KIM, KANG, PU, JIANTAO · 2022 to 2022
$2.2M
NCCIH NIH HHS R61 AT012282
6 · The paper itself

Abstract

Myofascial pain (MP) is a leading cause of chronic low back pain, yet its tissue-level drivers remain poorly defined and lack reliable image biomarkers. Existing studies focus predominantly on muscle while neglecting fascia, fat, and other soft tissues that play integral biomechanical roles. We developed an anatomically grounded explainable artificial intelligence (AI) framework, LAYER (Layer-wise Analysis for Yielding Explainable Relevance Tissue), that analyses six tissue layers in three-dimensional (3D) ultrasound and quantifies their contribution to MP prediction. By utilizing the largest multi-model 3D ultrasound cohort consisting of over 4,000 scans, LAYER reveals that non-muscle tissues contribute substantially to pain prediction. In B-mode imaging, the deep fascial membrane (DFM) showed the highest saliency (0.420), while in combined B-mode and shear-wave images, the collective saliency of non-muscle layers (0.316) nearly matches that of muscle (0.317), challenging the conventional muscle-centric paradigm in MP research and potentially affecting the therapy methods. LAYER establishes a quantitative, interpretable framework for linking layer-specific anatomy to pain physiology, uncovering new tissue targets and providing a generalizable approach for explainable analysis of soft-tissue imaging.

Identifiers

PMID41356067
PMCPMC12676424

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.