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  Metabolites of neuroinflammation relate to neuropathic pain after spinal cord injury

Pfyffer, D., Wyss, P. O., Huber, E., Curt, A., Henning, A., & Freund, P. (2020). Metabolites of neuroinflammation relate to neuropathic pain after spinal cord injury. Neurology, 95(7), e805-e814. doi:10.1212/WNL.0000000000010003.

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Pfyffer, Dario1, Author
Wyss, Patrik O.2, 3, 4, Author
Huber, Eveline1, Author
Curt, Armin1, Author
Henning, Anke2, 4, Author
Freund, Patrick5, 6, 7, 8, Author              
Affiliations:
1Balgrist Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland, ou_persistent22              
2Institute for Biomedical Engineering, University of Zurich, Switzerland, ou_persistent22              
3Department of Radiology, Swiss Paraplegic Research (SPF), Nottwill, Switzerland, ou_persistent22              
4Max Planck Institute for Biological Cybernetics, Tübingen, Germany, ou_persistent22              
5Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA, ou_persistent22              
6Department of Brain Repair & Rehabilitation, University College London, United Kingdom, ou_persistent22              
7Institute of Neurology, University College London, United Kingdom, ou_persistent22              
8Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_2205649              

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 Abstract: Objective: To determine whether cervical cord levels of metabolites are associated with pain sensation after spinal cord injury (SCI) by performing magnetic resonance spectroscopy in patients with SCI with and without neuropathic pain (NP). Methods: Cervical cord single-voxel spectroscopic data of 24 patients with SCI (14 with NP, 10 pain-free) and 21 healthy controls were acquired at C2/3 to investigate metabolite ratios associated with neuroinflammation (choline-containing compounds to myoinositol [tCho/mI]) and neurodegeneration (total N-acetylaspartate to myo-inositol [tNAA/mI]). NP levels were measured, and Spearman correlation tests assessed associations between metabolite levels, cord atrophy, and pinprick score. Results: In patients with NP, tCho/mI levels were increased (p = 0.024) compared to pain-free patients and negatively related to cord atrophy (p = 0.006, r = 0.714). Better pinprick score was associated with higher tCho/mI levels (p = 0.032, r = 0.574). In pain-free patients, tCho/mI levels were not related to cord atrophy (p = 0.881, r = 0.055) or pinprick score (p = 0.676, r = 0.152). tNAA/mI levels were similar in both patient groups (p = 0.396) and were not associated with pinprick score in patients with NP (p = 0.405, r = 0.242) and pain-free patients (p = 0.117, r = 0.527). Conclusions: Neuroinflammatory metabolite levels (i.e., tCho/mI) were elevated in patients with NP, its magnitude being associated with less cord atrophy and greater pain sensation (e.g., pinprick score). This suggests that patients with NP have more residual spinal tissue and greater metabolite turnover than pain-free patients. Neurodegenerative metabolite levels (i.e., tNAA/mI) were associated with greater cord atrophy but unrelated to NP. Identifying the metabolic NP signature provides new NP treatment targets and could improve patient stratification in interventional trials. Classification of evidence: This study provides Class II evidence that levels of magnetic resonance spectroscopy-identified metabolites of neuroinflammation were elevated in patients with SCI with NP compared to those without NP.

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Language(s): eng - English
 Dates: 2019-09-242020-01-272020-06-262020-08-18
 Publication Status: Published in print
 Pages: -
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 Table of Contents: -
 Rev. Type: -
 Identifiers: DOI: 10.1212/WNL.0000000000010003
Other: epub 2020
PMID: 32591473
PMC: PMC7605501
 Degree: -

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Title: Neurology
Source Genre: Journal
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Publ. Info: Cleveland, Ohio [etc.] : Advanstar Communications [etc.]
Pages: - Volume / Issue: 95 (7) Sequence Number: - Start / End Page: e805 - e814 Identifier: ISSN: 0028-3878
CoNE: https://pure.mpg.de/cone/journals/resource/954925246073