Supraspinal nociceptive networks in neuropathic pain after spinal cord injury

• Main Authors: Curt, A. (Author), Hubli, M. (Author), Huynh, V. (Author), Kollias, S. (Author), Luechinger, R. (Author), Lütolf, R. (Author), Michels, L. (Author), Rosner, J. (Author)
• Format: Article
• Language: English
• Published: John Wiley and Sons Inc 2021
• Subjects: adult; anterior cingulate; Article; brain region; clinical article; contact heat evoked potentials; controlled study; electrophysiology; evoked response; female; functional connectivity; human; insula; male; middle aged; nerve cell network; nerve cell plasticity; neuroimaging; neuropathic pain; nociception; nuclear magnetic resonance imaging; pain extent; pain intensity; paraplegia; phenotype; prefrontal cortex; quantitative sensory testing; resting-state functional connectivity; spinal cord injury; thalamus; voxel based morphometry; voxel-based morphometry
• Online Access: View Fulltext in Publisher

 Neuropathic pain following spinal cord injury involves plastic changes along the whole neuroaxis. Current neuroimaging studies have identified grey matter volume (GMV) and resting-state functional connectivity changes of pain processing regions related to neuropathic pain intensity in spinal cord injury subjects. However, the relationship between the underlying neural processes and pain extent, a complementary characteristic of neuropathic pain, is unknown. We therefore aimed to reveal the neural markers of widespread neuropathic pain in spinal cord injury subjects and hypothesized that those with greater pain extent will show higher GMV and stronger connectivity within pain related regions. Thus, 29 chronic paraplegic subjects and 25 healthy controls underwent clinical and electrophysiological examinations combined with neuroimaging. Paraplegics were demarcated based on neuropathic pain and were thoroughly matched demographically. Our findings indicate that (a) spinal cord injury subjects with neuropathic pain display stronger connectivity between prefrontal cortices and regions involved with sensory integration and multimodal processing, (b) greater neuropathic pain extent, is associated with stronger connectivity between the posterior insular cortex and thalamic sub-regions which partake in the lateral pain system and (c) greater intensity of neuropathic pain is related to stronger connectivity of regions involved with multimodal integration and the affective-motivational component of pain. Overall, this study provides neuroimaging evidence that the pain phenotype of spinal cord injury subjects is related to the underlying function of their resting brain. © 2021 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.