Lutke Schipholt Ivo J, Koop Meghan A, Coppieters Michel W, van de Giessen Elsmarieke M, Lammerstma Adriaan A, Ter Meulen Bastiaan C, Vleggeert-Lankamp Carmen, van Berckel Bart N M, Bot Joost, van Helvoirt Hans, Depauw Paul R, Boellaard Ronald, Yaqub Maqsood, Scholten-Peeters Gwendolyne
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences-Program Musculoskeletal Health, Van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands.
Laboratory Medical Immunology, Department of Clinical Chemistry, Amsterdam University Medical Centre, Location VUmc, 1081 HV Amsterdam, The Netherlands.
J Clin Med. 2025 Apr 2;14(7):2420. doi: 10.3390/jcm14072420.
The complex pathophysiology of painful cervical radiculopathy is only partially understood. Neuroimmune activation in the dorsal root ganglion and spinal cord is assumed to underlie the genesis of radicular pain. Molecular positron emission tomography (PET) using the radiotracer [C]DPA713, which targets the 18-kDa translocator protein (TSPO), offers the ability to quantify neuroinflammation in humans in vivo. The primary objectives of this study were to (1) assess whether uptake of [C]DPA713, a metric of neuroinflammation, is higher in the neuroforamina and spinal cord of patients with painful cervical radiculopathy compared with that in pain-free participants and (2) assess whether [C]DPA713 uptake is associated with clinical parameters, such as pain intensity. Dynamic 60 min [C]DPA713 PET/CT scans were acquired, and regions of interest were defined for neuroforamina and spinal cord. Resulting time-activity curves were fitted to a single-tissue compartment model using an image-derived input function, corrected for plasma-to-whole blood ratios and parent fractions, to obtain the volume of distribution () as the primary outcome measure. Secondary neuroinflammation metrics included 1T2k without metabolite correction (1T2k_WB) and Logan . The results indicated elevated levels of 1T2k at the neuroforamina ( < 0.04) but not at the spinal cord ( = 0.16). Neuroforamina and spinal cord 1T2k lack associations with clinical parameters. Secondary neuroinflammatory metrics show associations with clinical parameters such as the likelihood of neuropathic pain. These findings enhance our understanding of painful cervical radiculopathy's pathophysiology, emphasizing the neuroforamina levels of neuroinflammation as a potential therapeutic target.
疼痛性颈神经根病复杂的病理生理学仅得到部分理解。背根神经节和脊髓中的神经免疫激活被认为是神经根性疼痛发生的基础。使用放射性示踪剂[C]DPA713的分子正电子发射断层扫描（PET），该示踪剂靶向18 kDa转位蛋白（TSPO），能够在人体体内对神经炎症进行量化。本研究的主要目的是：（1）评估作为神经炎症指标的[C]DPA713在疼痛性颈神经根病患者的神经孔和脊髓中的摄取量是否高于无疼痛参与者；（2）评估[C]DPA713摄取量是否与疼痛强度等临床参数相关。进行了60分钟的动态[C]DPA713 PET/CT扫描，并为神经孔和脊髓定义了感兴趣区域。使用图像衍生输入函数将所得时间-活性曲线拟合到单组织隔室模型，校正血浆与全血比率和母体分数，以获得分布容积（）作为主要结局指标。次要神经炎症指标包括未进行代谢物校正的1T2k（1T2k_WB）和洛根图。结果表明，神经孔处的1T2k水平升高（<0.04），但脊髓处未升高（=0.16）。神经孔和脊髓的1T2k与临床参数缺乏相关性。次要神经炎症指标与诸如神经性疼痛可能性等临床参数存在关联。这些发现增进了我们对疼痛性颈神经根病病理生理学的理解，强调神经孔处的神经炎症水平作为潜在治疗靶点。
