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  Tissue bridges predict neuropathic pain emergence after spinal cord injury

Pfyffer, D., Vallotton, K., Curt, A., & Freund, P. (2020). Tissue bridges predict neuropathic pain emergence after spinal cord injury. Journal of Neurology, Neurosurgery & Psychiatry, 91(10), 1111-1117. doi:10.1136/jnnp-2020-323150.

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Item Permalink: https://hdl.handle.net/21.11116/0000-0007-0E0A-0 Version Permalink: https://hdl.handle.net/21.11116/0000-000D-350F-8
Genre: Journal Article

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 Creators:
Pfyffer, Dario1, Author
Vallotton, Kevin1, Author
Curt, Armin1, Author
Freund, Patrick1, 2, 3, 4, Author           
Affiliations:
1Balgrist Spinal Cord Injury Center, Balgrist University Hospital, Zürich, Switzerland, ou_persistent22              
2Department of Brain Repair & Rehabilitation, University College London, United Kingdom, ou_persistent22              
3Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, United Kingdom, ou_persistent22              
4Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_2205649              

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 Abstract: Objective To assess associations between preserved spinal cord tissue quantified by the width of ventral and dorsal tissue bridges and neuropathic pain development after spinal cord injury.

Methods This retrospective longitudinal study includes 44 patients (35 men; mean (SD) age, 50.05 (18.88) years) with subacute (ie, 1 month) spinal cord injury (25 patients with neuropathic pain, 19 pain-free patients) and neuroimaging data who had a follow-up clinical assessment at 12 months. Widths of tissue bridges were calculated from midsagittal T2-weighted images and compared across groups. Regression analyses were used to identify relationships between these neuroimaging measures and previously assessed pain intensity and pin-prick score.

Results Pin-prick score of the 25 patients with neuropathic pain increased from 1 to 12 months (Δmean=10.08, 95% CI 2.66 to 17.50, p=0.010), while it stayed similar in pain-free patients (Δmean=2.74, 95% CI −7.36 to 12.84, p=0.576). They also had larger ventral tissue bridges (Δmedian=0.80, 95% CI 0.20 to 1.71, p=0.008) at 1 month when compared with pain-free patients. Conditional inference tree analysis revealed that ventral tissue bridges’ width (≤2.1 or >2.1 mm) at 1 month is the strongest predictor for 12 months neuropathic pain intensity (1.90±2.26 and 3.83±1.19, p=0.042) and 12 months pin-prick score (63.84±28.26 and 92.67±19.43, p=0.025).

Interpretation Larger width of ventral tissue bridges—a proxy for spinothalamic tract function—at 1 month post-spinal cord injury is associated with the emergence and maintenance of neuropathic pain and increased pin-prick sensation. Spared ventral tissue bridges could serve as neuroimaging biomarkers of neuropathic pain and might be used for prediction and monitoring of pain outcomes and stratification of patients in interventional trials.

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Language(s): eng - English
 Dates: 2020-08-112020-10
 Publication Status: Issued
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: -
 Identifiers: DOI: 10.1136/jnnp-2020-323150
Other: epub 2020
PMID: 32788257
 Degree: -

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Project name : -
Grant ID : WFL-CH-007/14
Funding program : -
Funding organization : Wings for Life, Austria
Project name : -
Grant ID : IRP-P158
Funding program : -
Funding organization : International Foundation for Research in Paraplegia (IRP)
Project name : -
Grant ID : 681094
Funding program : Horizon 2020
Funding organization : European Union
Project name : -
Grant ID : 01EW1711A and B
Funding program : ERA-NET NEURON
Funding organization : Bundesministerium für Bildung und Forschung (BMBF)
Project name : -
Grant ID : PCEFP3_181362/1
Funding program : Eccellenza Professorial Fellowship
Funding organization : Schweizerischer Nationalfonds (SNF)
Project name : -
Grant ID : 091593/Z/10/Z
Funding program : -
Funding organization : Wellcome Trust

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Title: Journal of Neurology, Neurosurgery & Psychiatry
Source Genre: Journal
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Publ. Info: London : British Medical Association
Pages: - Volume / Issue: 91 (10) Sequence Number: - Start / End Page: 1111 - 1117 Identifier: ISSN: 0022-3050
CoNE: https://pure.mpg.de/cone/journals/resource/111085522793000