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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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 Urheber:
Pfyffer, Dario1, Autor
Vallotton, Kevin1, Autor
Curt, Armin1, Autor
Freund, Patrick1, 2, 3, 4, Autor           
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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 Zusammenfassung: 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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Sprache(n): eng - English
 Datum: 2020-08-112020-10
 Publikationsstatus: Erschienen
 Seiten: -
 Ort, Verlag, Ausgabe: -
 Inhaltsverzeichnis: -
 Art der Begutachtung: -
 Identifikatoren: DOI: 10.1136/jnnp-2020-323150
Anderer: epub 2020
PMID: 32788257
 Art des Abschluß: -

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

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Titel: Journal of Neurology, Neurosurgery & Psychiatry
Genre der Quelle: Zeitschrift
 Urheber:
Affiliations:
Ort, Verlag, Ausgabe: London : British Medical Association
Seiten: - Band / Heft: 91 (10) Artikelnummer: - Start- / Endseite: 1111 - 1117 Identifikator: ISSN: 0022-3050
CoNE: https://pure.mpg.de/cone/journals/resource/111085522793000