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Microstructural plasticity in nociceptive pathways after spinal cord injury
Sreenath P Kyathanahally1, Michela Azzarito1, Jan Rosner1,2
1Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland.
Journal of Neurology, Neurosurgery, and Psychiatry
|May 27, 2021
Summary
Microstructural changes in pain pathways after spinal cord injury (SCI) are linked to neuropathic pain (NP). Tracking these neurodegenerative and compensatory changes aids patient monitoring in pain and neuroregeneration trials.
Area of Science:
- Neuroscience
- Radiology
- Pain Medicine
Background:
- Neuropathic pain (NP) following spinal cord injury (SCI) involves complex changes in the nervous system.
- Understanding the microstructural alterations in nociceptive pathways is crucial for managing NP.
Purpose of the Study:
- To investigate the relationship between microstructural changes in nociceptive pathways and the presence/intensity of NP after SCI.
- To track alterations along the entire neuroaxis in individuals with and without NP.
Main Methods:
- Quantitative neuroimaging using multiparametric mapping (magnetisation transfer, R1, R2*) to assess myelination and iron content.
- Combined brain and spinal cord template with statistical parametric mapping.
- Multivariate source-based morphometry to identify structural variations.
Main Results:
- Individuals with NP showed altered R1, MT, and R2* values in brain regions (PFC, M1, ACC) and spinal cord.
- Specific changes in the periaqueductal grey (PAG) and cervical cord correlated with NP intensity.
- Evidence of microstructural changes across ascending and descending nociceptive pathways.
Conclusions:
- Microstructural changes in nociceptive pathways are integral to maintaining NP after SCI.
- Monitoring these maladaptive plasticity changes can help track neurodegenerative and compensatory processes.
- This approach may aid patient monitoring in pain and neuroregeneration therapeutic trials.
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