Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
J Spinal Cord Med. 2021 Sep;44(5):794-799. doi: 10.1080/10790268.2020.1786321. Epub 2020 Jul 9.
Little is understood about differences in resting neural activity among those with spinal cord injury (SCI)-related neuropathic pain. The purpose of this pilot study was to determine resting cerebral blood flow differences in persons with SCI-related neuropathic pain compared to healthy, pain-free able-bodied controls. Five persons with paraplegia and ten able-bodied participants were included in this study. Resting blood flow, as measured by a continuous arterial spin labeling (ASL) method of fMRI, was analyzed via statistical parametric mapping. Persons with SCI-related neuropathic pain had significantly lower resting blood flow in the cerebellum (Crus I/II), rostral ventromedial medulla and left insular cortex. In contrast, greater resting blood flow occurred in the medial orbitofrontal cortex among those with SCI-related neuropathic pain compared to controls. Differences in resting blood flow were observed among those with SCI-related pain, particularly in regions that may be involved in affective-motivational and cognitive-evaluative aspects of pain. Larger ASL studies in addition to functional connectivity studies using fMRI are needed to clarify unique neural patterns in this complex and often intractable form of pain.
对于脊髓损伤（SCI）相关神经性疼痛患者之间静息神经活动的差异，人们知之甚少。本初步研究的目的是确定 SCI 相关神经性疼痛患者与健康、无痛的健全对照组之间的静息脑血流差异。本研究纳入了 5 名截瘫患者和 10 名健全参与者。通过功能磁共振成像（fMRI）的连续动脉自旋标记（ASL）方法测量静息血流，并通过统计参数映射进行分析。与对照组相比，SCI 相关神经性疼痛患者小脑（Crus I/II）、腹内侧髓质和左侧岛叶皮质的静息血流明显降低。相比之下，SCI 相关神经性疼痛患者的眶额内侧皮质的静息血流更高。在与 SCI 相关的疼痛患者中观察到静息血流的差异，特别是在可能涉及疼痛的情感动机和认知评估方面的区域。需要更大的 ASL 研究以及 fMRI 的功能连接研究，以阐明这种复杂且常常难以治疗的疼痛形式的独特神经模式。
